Case Study 3 •Rebecca Turner, a 32-year-old woman presents to the emergency department with complaints of involuntary hand spasms. She states that as she was folding laundry, she had a sudden severe spasm of her right hand such that her fingers flexed. The spasm was quite painful and lasted several minutes, resolving spontaneously. Her medical history is notable for thyroid tumor status post (S/P) thyroidectomy 3 years ago. She is taking synthetic thyroid hormone. Family history is unremarkable. On physical examination, she has positive Chvostek's and Trousseau's signs. Examination is otherwise unremarkable.

The subject of this question is Medicine. The case study describes a 32-year-old woman with involuntary hand spasms after thyroid surgery. The patient's positive Chvostek's and Trousseau's signs suggest hypoparathyroidism, a condition characterized by low calcium levels.

Explanation:

The subject of this question is Medicine. The case study describes a 32-year-old woman who presents with involuntary hand spasms. The patient has a medical history of thyroid tumor and is taking synthetic thyroid hormone. The physical examination shows positive Chvostek's and Trousseau's signs. These findings are suggestive of hypoparathyroidism, which can occur as a complication after thyroidectomy.

Hypoparathyroidism is a condition characterized by inadequate production or action of the parathyroid hormone (PTH). PTH plays a crucial role in maintaining calcium and phosphate balance in the body. When PTH levels are low, calcium levels decrease and phosphate levels increase, leading to symptoms such as muscle spasms, including the involuntary hand spasms described in the case study.

The positive Chvostek's sign is observed when tapping the facial nerve in front of the ear causes a facial twitch, indicating increased neuronal excitability due to low calcium levels. The positive Trousseau's sign occurs when inflating a blood pressure cuff on the arm causes carpal spasm, again indicating increased neuronal excitability. These signs are commonly seen in hypoparathyroidism due to low calcium levels.

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