Which signs would you assess to monitor for hypocalcemia after thyroidectomy?

• A. Chvostek sign
• B. Trousseau sign
• C. Both Chvostek and Trousseau signs
• D. Kussmaul sign

Answer: (C)

Hypocalcemia after thyroidectomy is a concern because the parathyroid glands can be affected, reducing PTH and calcium levels. Low calcium makes nerves more excitable, leading to detectable signs of tetany. Two classic bedside indicators of this state are Chvostek sign—tapping the facial nerve in front of the ear causes facial muscle twitching—and Trousseau sign—inflating a blood pressure cuff above systolic pressure for a few minutes provokes a carpopedal spasm. These signs directly reflect the heightened neuromuscular excitability of hypocalcemia and are used to monitor for this complication after thyroid surgery. Kussmaul sign, by contrast, is not related to calcium status.