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MMLU / A 60-year-old man had a total thyroidectomy and excision of enlarged left…

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question

A 60-year-old man had a total thyroidectomy and excision of enlarged left jugular lymph nodes for follicular carcinoma. The operation was uncomplicated. He is receiving intravenous 5% dextrose and 0.45% saline with potassium. Twelve hours after the operation he develops circumoral numbness and paresthesias in his fingertips, and he becomes very anxious. Vital signs are temperature 37.6°C (99.7°F), pulse 90/min, respirations 16/min, and blood pressure 140/90 mm Hg. Physical examination discloses a dry neck dressing and no stridor. Extremities are warm, with brisk capillary refill time. Additional physical examination is most likely to show which of the following?

choices

  1. Babinski sign present bilaterally
  2. Chvostek sign
  3. Deviation of the tongue to the left side
  4. A drooping left shoulder

subject

professional_medicine

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