Post-Surgical Hypoparathyroidism — RACP Adult Medicine MCQ

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EasyEndocrinologyPost-Surgical HypoparathyroidismRACP Adult Medicine

A 55-year-old woman post-thyroidectomy presents with perioral tingling, carpopedal spasm, and a positive Chvostek sign. ECG shows prolonged QTc interval. Corrected calcium is 1.65 mmol/L, phosphate 2.1 mmol/L, PTH <0.5 pmol/L, magnesium 0.85 mmol/L. What is the most likely electrolyte abnormality causing symptoms?

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Correct answer: B — Hypocalcaemia

Post-thyroidectomy hypocalcaemia from hypoparathyroidism (PTH suppressed/absent) presents with neuromuscular irritability (perioral tingling, carpopedal spasm, Trousseau sign, Chvostek sign) and prolonged QTc. Treatment is IV calcium gluconate 10% (20 mL over 10 minutes) for symptomatic hypocalcaemia, followed by oral calcium and calcitriol for maintenance.

Reference: eTG Endocrine – 2024 – Hypocalcaemia; ESA 2024