Orthopaedic Nurses Certification Board (ONCB) Metabolic/Inflammatory/Tumors Practice Exam

Which clinical sign is suggestive of hypoparathyroidism?

1. Newly negative Trousseau's phenomenon

2. Hypoactive deep tendon reflexes

3. Bradycardia

4. Newly positive Chvostek's sign

The correct answer is: Newly positive Chvostek's sign

Newly positive Chvostek's sign is indicative of hypoparathyroidism due to its association with hypocalcemia, which is a common result of inadequate parathyroid hormone (PTH) levels. Chvostek's sign is elicited by tapping the facial nerve near the ear, leading to twitching of the facial muscles on the same side. This reflexive response occurs because low calcium levels sensitize the neurons and increase excitability, making them responsive even to small stimuli. In patients with hypoparathyroidism, the lack of PTH leads to decreased calcium levels in the blood. Therefore, the presence of a positive Chvostek's sign becomes a clinical marker to suggest that hypoparathyroidism may be affecting calcium homeostasis. This is particularly relevant in the context of metabolic and inflammatory disorders where calcium levels are crucial for various cellular functions. The other clinical signs provided do not reliably point to hypoparathyroidism. For instance, a newly negative Trousseau's phenomenon and hypoactive deep tendon reflexes indicate different conditions or variations of muscle and nerve function and do not correlate specifically with hypoparathyroidism. Bradycardia, while it can occur in various metabolic disturbances, is not a direct