Question

A 45-year-old female patient underwent a thyroidectomy. Three days after the surgery, she developed perioral numbness. Which of the following investigations need to be done for her?

• A. Free T3, T4
• B. T3, T4, thyroid–stimulating hormone
• C. Radioiodine scan
• D. Calcium, phosphate, and parathormone levels

Answer 1

The Correct Option is D

After a thyroidectomy, patients are at risk of developing hypocalcemia due to potential damage or removal of the parathyroid glands, which are responsible for regulating calcium levels in the body. The perioral numbness experienced by the patient is a common symptom of hypocalcemia. To evaluate this condition, it is essential to check the patient's calcium, phosphate, and parathormone (PTH) levels. Here's why each is important:

• Calcium Levels: Low calcium levels can confirm hypocalcemia. It is crucial to monitor since post-surgical hypoparathyroidism can lead to an acute drop in calcium levels.
• Phosphate Levels: In hypoparathyroidism, phosphate levels can be elevated due to decreased renal excretion. Assessing phosphate levels can help in diagnosing the underlying cause of the patient's symptoms.
• Parathormone (PTH) Levels: PTH is directly involved in maintaining calcium homeostasis. Low PTH levels post-surgery might indicate hypoparathyroidism, contributing to hypocalcemia.

Thus, the investigation of calcium, phosphate, and parathormone levels is the most appropriate next step in managing this patient. This diagnosis helps in confirming hypoparathyroidism and guiding the treatment plan, which may include calcium and vitamin D supplementation.