Question

Given below are two statements : One is labelled as Assertion (A) and the other is labelled as Reason (R). Statement I : Hypoparathyroidism presents as neuromuscular irritability and neuropsychiatric manifestations. Chvostek’s sign and Trousseau’s sign are found in hypocalcemia. Statement II : Chvostek’s sign (gentle tapping over the trigeminal nerve causes twitching of the ipsilateral facial muscles) and Trousseau’s sign (inflation of the sphygmomanometer cuff above systolic pressure for 5 minutes induces tetanic spasm of the fingers and wrist). In the light of the above statements, choose the most appropriate answer from the options given below :

• A. \( \text{Both Statement I and Statement II are correct} \)
• B. \( \text{Both Statement I and Statement II are incorrect} \)
• C. \( \text{Statement I is correct but Statement II is incorrect} \)
• D. \( \text{Statement I is incorrect but Statement II is correct} \)

Hint:

\textbf{Endocrinology: Hypocalcemia Signs.} Remember that Chvostek's sign involves tapping the facial nerve, and Trousseau's sign involves inflating a blood pressure cuff to elicit carpopedal spasm, both indicating neuromuscular excitability due to hypocalcemia.

Answer 1

The Correct Option is C

Let's analyze each statement regarding hypoparathyroidism and its associated signs: Statement I: Hypoparathyroidism presents as neuromuscular irritability and neuropsychiatric manifestations. Chvostek’s sign and Trousseau’s sign are found in hypocalcemia. Hypoparathyroidism leads to decreased parathyroid hormone (PTH) levels, resulting in hypocalcemia (low blood calcium). Hypocalcemia increases neuromuscular excitability, leading to symptoms like paresthesias, muscle cramps, tetany, and even seizures. Neuropsychiatric manifestations such as anxiety, depression, and psychosis can also occur. Chvostek's sign and Trousseau's sign are classic physical examination findings indicative of hypocalcemia. Therefore, Statement I is correct. Statement II: Chvostek’s sign (gentle tapping over the trigeminal nerve causes twitching of the ipsilateral facial muscles) and Trousseau’s sign (inflation of the sphygmomanometer cuff above systolic pressure for 5 minutes induces tetanic spasm of the fingers and wrist). Chvostek's sign is elicited by gently tapping over the facial nerve (not the trigeminal nerve) just anterior to the ear, near the angle of the jaw. A positive sign is the twitching of the ipsilateral facial muscles (typically the lip or nose). Trousseau's sign is elicited by inflating a sphygmomanometer cuff above the patient's systolic blood pressure for 2-3 minutes (not 5 minutes), which can induce carpopedal spasm (tetanic spasm of the fingers and wrist). Therefore, Statement II contains inaccuracies regarding both the nerve stimulated for Chvostek's sign and the duration of cuff inflation for Trousseau's sign, making it incorrect. In conclusion, Statement I is correct, but Statement II is incorrect.