Between 1 hour and 48 hours after thyroid surgery, which complication is expected with total thyroidectomy?

• A. Tetany due to hypocalcemia
• B. Storm due to thyrotoxicosis
• C. Hyperkalemia
• D. Hypoglycemia

Answer: (A)

Loss or damage to the parathyroid glands during total thyroidectomy can lead to hypoparathyroidism, which causes a drop in calcium levels. Parathyroid hormone normally maintains calcium by increasing bone resorption, boosting kidney calcium reabsorption, and enhancing active vitamin D production for intestinal calcium absorption. When PTH falls, serum calcium falls rapidly, and neuromuscular irritability appears as tingling, cramps, and tetany—often within the first day or two after surgery. That makes tetany due to hypocalcemia the expected complication in this 1–48 hour window.

Thyroid storm is a potential risk in hyperthyroid patients undergoing surgery but is not the typical postoperative complication within this timeframe. Hyperkalemia and hypoglycemia aren’t direct consequences of thyroidectomy in this context.