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Medicine General 32c401bd

Chvostek’s sign is elicited by

A
BP cuff in arm for 5 minutes
B
Facial nerve stimulation by tapping over the parotid
C
Tapping over extensor pollicis brevis
D
Tapping over flexor retinaculum
High-Yield Explanation
The Clinical manifestations of hypocalcemia are mostly due to neuromuscular irritability.  The patients complains of paresthesias which are typically perioral or of the hands and feets  Tetany is the classic manifestation of hypocalcemia, the manifestations are :  Corpopedal Spasm o Laryngospasm o Seizures Latent tetany occurs which can be manifested by Chvostek sign and  Trousseau sign Electrocardiographic manifestations The classic E.C.G. change with hypocalcemia is prolonged corrected QT interval Other possible E. C. G. findings are o Prolonged ST interval o Peaked T waves o Arryhtmmias Heart block (hypocalcemia may impair cardiac contractility and decrease blood pressure) GI. T manifestations o Intestinal cramps and malabsorption NOTE: Corpopedal spasm: o Contraction the muscels of the hand and feet. The wrists are flexed and fingers extended, with the thumbs adducted over the palms. Chvostek sign: Tapping the facial nerve anterior to the external auditory meatus elicits a twitch of the upper lip or entire mouth. This is not a very specific sign because it is positive in about 10% of patients without hypocalcemia. Trousseau sign:  A blood pressure cuff is inflated slightly above the systotic blood pressure for more than 3 minutes. Corpopedal spasm occurs if hypocalcemia is present as a result of the ischemia of motor nerves.

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