What is one of the earliest signs of hypocalcemia?

• A. Numbness and tingling of the lips.
• B. Fever.
• C. Coughing.
• D. Bradycardia

Answer: (A)

Paresthesias around the lips and in the fingertips and toes are among the earliest signs of hypocalcemia. When calcium levels drop, nerves become more excitable because the threshold for triggering action potentials is lowered. That increased neuronal irritability manifests as tingling and numbness in areas supplied by nerves, especially around the mouth and in the hands and feet. As calcium deficiency progresses, you might also see muscle cramps or tetany, and signs like Chvostek’s or Trousseau’s can appear.

Fever, coughing, and bradycardia are not early signs of low calcium. Fever points to infection or inflammatory processes, coughing isn’t a specific early sign of electrolyte imbalance, and bradycardia can occur in various conditions but isn’t typically an early indicator of hypocalcemia.