When treating hypocalcemia secondary to hypoparathyroidism treatment can be further intensified by all EXCEPT

A. Thiazide diuretics

B. Phosphate binders

C. Low-salt diet

D. High-phosphorus diet

Tapping of facial nerve branches leading to twitching of facial muscle is

A. Gordon’s sign

B. Chvostek sign

C. Trousseau sign

D. Troisier’s sign

Chvostek’s sign may be found in all EXCEPT

A. Tetany

B. Hypermagnesemia

C. Respiratory alkalosis

D. Diuretics

Deficiency of 1,25-dihydroxy vitamin D mainly affect calcium metabolism by

A. Reduction in gastrointestinal calcium absorption

B. Impaired renal hydroxylation

C. Increased catabolism

D. Impaired hepatic hydroxylation

Inadequate vitamin D levels lead to a reduction in gastrointestinal calcium absorption of up to

A. 20%

B. 30%

C. 40%

D. 50%

Carpal spasm in response to forearm ischemia caused by inflation of a sphygmomanometer cuff is called

A. Gordon’s sign

B. Chvostek sign

C. Trousseau sign

D. Troisier’s sign


Chvostek sign – type I

How to elicit Chvostek-I sign

It is obtained by striking with a finger or a hammer a point that is approximately 2 cm in front of the lobe of the ear and about 1 cm below the zygomatic process.


Response occurs in the form of ipsilateral contraction of some or all of the muscles innervated by the facial nerve.


The effect is the lateral deviation of the labial and nasal fold toward the stimulated side.

Chvostek sign – type II

Hitting a point between the middle third and upper third of the line joining the angle of the mouth to the zygomatic process gives rise to only a contraction of the muscles of the mouth and nose

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