AIIMS Delhi NO - 2018
Medical & Surgical Nursing
Easy
Trousseau's sign is seen in?
Appeared in: AIIMS Delhi NO - 2018
Explanation
- Trousseau's sign is a classic clinical manifestation of hypocalcemia (low serum calcium).
- It is characterized by a carpopedal spasm that occurs when blood flow to the arm is occluded, typically with a blood pressure cuff.
- Low calcium levels increase the excitability of nerve and muscle tissues, leading to involuntary contractions (tetany) when provoked by ischemia.
- The sign is considered more specific for hypocalcemia than Chvostek's sign.
Why Other Options Were Wrong
- Option B: Hypercalcemia (high calcium) decreases neuromuscular excitability, leading to muscle weakness and fatigue, not the spasms seen in Trousseau's sign.
- Option C: Hypokalemia (low potassium) causes generalized muscle weakness, arrhythmias, and fatigue. It does not cause the specific tetanic spasm of Trousseau's sign.
- Option D: Hyperkalemia (high potassium) is a critical condition that leads to muscle weakness, paralysis, and life-threatening cardiac arrhythmias (like peaked T waves). It does not cause tetany.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Clinical signs of electrolyte imbalances, specifically hypocalcemia as background academic context rather than a clinical decision trigger.
- A positive Trousseau's sign is a critical finding that requires prompt notification of the primary healthcare provider.
- Nurses should immediately assess for other signs of hypocalcemia, such as Chvostek's sign, paresthesias, and muscle twitching, and monitor the patient's airway and cardiac rhythm.
- What if? If a patient has a positive Trousseau's sign but also has chronic kidney disease, the cause is likely multifactorial (impaired vitamin D activation, hyperphosphatemia) and treatment will involve not just calcium but also phosphate binders and vitamin D analogs.
How to Approach the Question
- First, identify the core concept of the question, which is the clinical sign 'Trousseau's sign'.
- Recall or deduce the pathophysiology associated with this sign. Trousseau's sign is a form of tetany, which points to neuromuscular hyperexcitability.
- Consider the role of each electrolyte in neuromuscular function. Calcium plays a key role in stabilizing nerve cell membranes.
- Evaluate the options: Low calcium (hypocalcemia) would destabilize membranes, causing hyperexcitability. High calcium (hypercalcemia) would have the opposite effect. Potassium imbalances primarily affect muscle and cardiac function in different ways.
- Conclude that hypocalcemia is the only option that causes the tetany manifested as Trousseau's sign.
Concept Tested & Keywords
- Concept Tested: Clinical signs of electrolyte imbalances, specifically hypocalcemia.
- Stem keywords: Trousseau's sign
- Lead-in keywords: is seen in
Question ID
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Reference Book
E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed p. 1096-1098
E6 Nursing Brunner Adult Health 3SA Vol 1 Part 4 p. 30-32
E6 Medicine Harrison 22e Part 2 p. 1190-1192
Practise the full AIIMS Delhi NO - 2018
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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