A 38yo pt presented with tingling, numbness, paraesthesia, resp stridor and involuntary spasm
of the upper extremities. She has undergone surgery for thyroid carcinoma a week ago. What is
the most likely dx?
a. Thyroid storm
b. Hyperparathyroidism
c. Unilateral recurrent laryngeal nerve injury
d. External laryngeal nerve injury
e. Hypocalcemia
answer E
acute hyocalcemia
Paresthesia
Laryngospasm (with stridor)
Hyperreflexia
Tetany
Chvostek’s sign (tap CN VII)
Trousseau’s sign (carpal spasm)
ECG changes
Delirium
Psychiatric Sx: emotional instability,
anxiety, and depression
Recurrent laryngeal nerve injury
-unilateral: hoarseness or asymptomatic due to compensation from the other side
-bilateral: aphonia, air way narrowing
External laryngeal nerve injury
- weakness of voice
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