AIIMS M.Sc. Nsg Entrance exam-2026
Medical Surgical Nursing
Medium
In case of hyperparathyroidism, which of the following will be seen?
Appeared in: AIIMS M.Sc. Nsg Entrance exam-2026
Explanation
- Hyperparathyroidism causes an excess of parathyroid hormone (PTH), which increases bone resorption and renal calcium reabsorption, leading to hypercalcemia (high serum calcium).
- Hypercalcemia alters the cardiac action potential by shortening the plateau phase (Phase 2).
- This acceleration of ventricular repolarization manifests on the ECG as a shortened QT interval.
- The provided image visually confirms this, showing a clear example of a short QT interval in the context of hypercalcemia.
Why Other Options Were Wrong
- Option B: A prolonged QT interval is associated with the opposite condition, hypocalcemia (low calcium levels), where ventricular repolarization is delayed.
- Option C: Tall, peaked, or 'tented' T waves are a hallmark sign of hyperkalemia (high potassium levels), not hypercalcemia.
- Option D: ST-segment elevation is a critical finding that typically indicates transmural myocardial ischemia or injury (e.g., a heart attack) or acute pericarditis. It is not a direct result of hypercalcemia.
Related Visual
- Visual 1: Infographic - A comparative chart showing the distinct ECG waveforms for the four key electrolyte imbalances: hyperkalemia (peaked T wave), hypokalemia (U wave), hypercalcemia (short QT), and hypocalcemia (long QT). This helps in differentiating the patterns.
- Visual 2: Diagram - An illustration of the cardiac action potential phases, highlighting how high extracellular calcium shortens Phase 2 (the plateau), thereby reducing the overall action potential duration and the corresponding QT interval.
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain ECG interpretation in electrolyte imbalances, specifically hypercalcemia secondary to hyperparathyroidism as background academic context rather than a clinical decision trigger.
- Nurses must be vigilant in monitoring the ECG of patients with known or suspected hyperparathyroidism or other causes of hypercalcemia.
- While a prolonged QT interval is more commonly associated with arrhythmias like Torsades de Pointes, a significantly shortened QT interval can also increase the risk of ventricular arrhythmias and sudden cardiac death.
- What if? If the patient had undergone a thyroidectomy and accidentally had their parathyroid glands removed (iatrogenic hypoparathyroidism), the nurse would expect to see the opposite ECG finding: a prolonged QT interval due to hypocalcemia.
How to Approach the Question
- First, identify the core condition in the question stem: 'hyperparathyroidism'.
- Next, recall the primary physiological consequence of this condition. Hyperparathyroidism leads to increased parathyroid hormone (PTH), which results in hypercalcemia (high blood calcium).
- Connect this physiological change to the specific clinical sign asked about in the question, which is an ECG finding.
- Recall the specific effect of hypercalcemia on the heart's electrical cycle. High calcium speeds up ventricular repolarization.
- Translate this effect into an ECG waveform. Accelerated repolarization results in a shortened QT interval.
- Evaluate the given options. Select 'Short QT interval' and systematically eliminate the other options by linking them to different conditions (e.g., prolonged QT to hypocalcemia, peaked T waves to hyperkalemia).
Concept Tested & Keywords
- Concept Tested: ECG interpretation in electrolyte imbalances, specifically hypercalcemia secondary to hyperparathyroidism.
- Stem keywords: hyperparathyroidism, ECG
- Lead-in keywords: will be seen
Question ID
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