What are the typical signs of postoperative hypocalcemia after thyroid/parathyroid surgery?

• A. Headache and diplopia; treat with acetaminophen.
• B. Fever and warmth; treat with aspirin.
• C. Nausea only; no treatment.
• D. Tetany, perioral numbness, tingling; positive Chvostek or Trousseau signs; treat with calcium supplementation.

Answer: (D)

Postoperative hypocalcemia after thyroid or parathyroid surgery happens when the parathyroid glands aren’t functioning well, leading to low calcium levels. This causes neuromuscular irritability, so you see tetany and tingling around the mouth and in the fingertips, along with perioral numbness. Classic signs like Chvostek and Trousseau reflect this increased excitability. The appropriate management is calcium supplementation, often starting with calcium (sometimes IV if symptomatic) and continuing to maintain calcium levels, with possible addition of vitamin D analogs to help absorption. Other options don’t fit these neuromuscular symptoms that point to low calcium after this type of surgery.