A 45-year-old diagnosed with Graves disease underwent surgical removal of the thyroid gland. During the postoperative period, the patient's serum calcium is low. The most probable reason for her low serum calcium is:
a. hyperparathyroidism secondary to Graves disease.
b. myxedema secondary to surgery.
c. hypoparathyroidism caused by surgical injury to the parathyroid glands.
d. hypothyroidism resulting from lack of thyroid replacement.
ANS: C
Hypoparathyroidism is most commonly caused by damage to the parathyroid glands during thy-roid surgery, not secondary to Graves disease, myxedema, or the lack of thyroid replacement.
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