What is the most likely cause of tetany after thyroidectomy?
a. Excess circulating thyroid hormone released during manipulation of the gland during surgery
b. Swelling of the incisional area
c. Overdose of preoperative antithyroid medication
d. Accidental removal of the parathyroids during surgery
ANS: D
Tetany can occur if the parathyroid glands are accidentally removed during thyroid surgery. Because of the proximity of the parathyroid glands to the thyroid, it is sometimes difficult for the surgeon to avoid them. In the absence of parathyroid hormone, serum calcium levels drop, and tetany results. Excess thyroid hormone causes a thyrotoxic crisis. Swelling and antithyroid medication do not cause tetany.
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