Combined AIIMS - 2020 (Jodhpur, Bhopal, Patna, Raipur)
Medical & Surgical Nursing
Easy
Identify the sign and what deficiency caused it:
Appeared in: Combined AIIMS - 2020 (Jodhpur, Bhopal, Patna, Raipur)
Explanation
- The image shows a carpopedal spasm, also known as 'main d'accoucheur' (obstetrician's hand).
- This specific spasm is the hallmark of a positive Trousseau's sign.
- Trousseau's sign is elicited by inducing ischemia in the arm (e.g., with a blood pressure cuff) and indicates neuromuscular excitability.
- This increased excitability, or latent tetany, is a classic manifestation of hypocalcemia (serum calcium level below 8.6 mg/dL).
Why Other Options Were Wrong
- Option A: The image does not show Chvostek's sign. Chvostek's sign involves twitching of the facial muscles, not a spasm of the hand.
- Option C: While hypomagnesemia can cause muscle twitching, the image displays a very specific and characteristic carpopedal spasm known as Trousseau's sign, which is more directly associated with hypocalcemia.
- Option D: This option is incorrect because a correct sign and its associated deficiency are listed in the options and clearly depicted in the image.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Identification of clinical signs associated with electrolyte imbalances, specifically hypocalcemia as background academic context rather than a clinical decision trigger.
- Recognizing Trousseau's and Chvostek's signs is a critical nursing skill for the early detection of hypocalcemia, which can lead to life-threatening complications like seizures and laryngospasm.
- Nurses should be particularly vigilant for these signs in at-risk patients, such as those who have undergone thyroid or parathyroid surgery, patients with pancreatitis, or those with chronic kidney disease.
- What if? If a post-thyroidectomy patient develops numbness and tingling around the mouth (circumoral paresthesia) and a positive Trousseau's sign, the nurse's priority action is to ensure a patent airway, notify the provider immediately, and prepare for IV calcium administration, as this indicates significant hypocalcemia.
How to Approach the Question
- First, carefully analyze the image provided. Identify the specific anatomical features and the action or posture being displayed. In this case, note the unique flexion of the wrist and fingers, and adduction of the thumb.
- Recognize this specific posture as carpopedal spasm, also known as 'main d'accoucheur'.
- Recall or deduce that carpopedal spasm is the key feature of a positive Trousseau's sign.
- Connect Trousseau's sign to its underlying cause. This sign is a classic indicator of latent tetany due to hypocalcemia.
- Evaluate the given options. Option B, 'Trousseau sign: Hypocalcemia,' directly matches your analysis of the image and its clinical significance.
- Briefly consider the other options to confirm they are incorrect. Chvostek's sign involves the face, and while hypomagnesemia causes twitching, it's not the specific sign shown.
Concept Tested & Keywords
- Concept Tested: Identification of clinical signs associated with electrolyte imbalances, specifically hypocalcemia.
- Stem keywords: Identify the sign, deficiency, hypocalcemia, hypomagnesiemia
- Lead-in keywords: Identify
- Clinical cues: The image shows a specific hand posture (carpopedal spasm), which is a key diagnostic clue.
Question ID
Qj8POSr6bSnrR5oCa3fUPT
Reference Book
E6 Nursing Brunner Adult Health 3SA Vol 1 Part 1 p. 154-156
E6 Nursing Brunner Adult Health 3SA Vol 1 Part 4 p. 30-32
E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed p. 1096-1098
Practise the full Combined AIIMS - 2020 (Jodhpur, Bhopal, Patna, Raipur)
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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