Orthopaedic Nurses Certification Board (ONCB) Metabolic/Inflammatory/Tumors Practice Exam

What is a common physical sign seen in patients with hypoparathyroidism?

1. Positive Trousseau's sign

2. High blood pressure

3. Persistent muscle cramps

4. Newly positive Chvostek's sign

The correct answer is: Newly positive Chvostek's sign

In the context of hypoparathyroidism, a newly positive Chvostek's sign is indeed a common physical manifestation. Chvostek's sign is elicited by tapping on the facial nerve, which results in twitching of the facial muscles on the same side. This reaction occurs due to the neuromuscular excitability that arises from low calcium levels in the blood, a hallmark of hypoparathyroidism. The disease leads to deficient parathyroid hormone (PTH) levels, which are crucial for maintaining calcium homeostasis. Consequently, the resulting hypocalcemia can facilitate increased neuromuscular excitability, hence the relevance of Chvostek's sign in diagnosing hypoparathyroidism. Trousseau's sign, which is related to muscle spasms triggered by blood pressure cuff inflation, may also be associated with hypocalcemia but is less frequently observed in patients specifically presenting with hypoparathyroidism compared to Chvostek's sign. High blood pressure is not characteristic of hypoparathyroidism; in fact, patients often experience low blood pressure due to issues with calcium dynamics affecting vascular tone. Persistent muscle cramps can occur but are not as definitive as the Chvostek's sign for identifying