Which signs indicate neuromuscular irritation in hypocalcemia?

• A. Trousseau's and Chvostek
• B. Hyperreflexia
• C. Positive Babinski
• D. Nystagmus

Answer: (A)

Low calcium makes nerve membranes more likely to fire, so the nerves and muscles become unusually excitable. This classic neuromuscular irritability shows up in bedside signs like the facial twitch when the cheek is tapped (Chvostek sign) and the involuntary hand and finger spasms that occur when a blood pressure cuff is inflated (Trousseau sign). Both reflect that peripheral nerves and skeletal muscles are more readily depolarized and activated due to hypocalcemia.

Other findings like hyperreflexia can occur with increased neural excitability, but they’re not as specific for low calcium. Signs such as a positive Babinski or nystagmus point to different neurological processes and aren’t characteristic of hypocalcemic neuromuscular irritability.