Endocrine System Disorders Q 17 - Gyan Darpan : Learning Portal
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Saturday, 9 April 2022

Endocrine System Disorders Q 17

A female client has a serum calcium level of 7.2 mg/dl. During the physical examination, nurse Noah expects to assess:
    A. Trousseau’s sign.
    B. Homans’ sign.
    C. Hegar’s sign.
    D. Goodell’s sign.

Correct Answer: A. Trousseau’s sign.

This client’s serum calcium level indicates hypocalcemia, an electrolyte imbalance that causes Trousseau’s sign (carpopedal spasm induced by inflating the blood pressure cuff above systolic pressure). Trousseau’s sign for latent tetany is most commonly positive in the setting of hypocalcemia. The sign is observable as a carpopedal spasm induced by ischemia secondary to the inflation of a sphygmomanometer cuff, commonly on an individual’s arm, to 20 mmHg over their systolic blood pressure for 3 minutes. The carpopedal spasm is visualized as flexion of the wrist, thumb, and metacarpophalangeal joints with hyperextension of the fingers.

Option B: Homans’ sign (pain on dorsiflexion of the foot) indicates deep vein thrombosis. A positive Homan’s sign (calf pain at dorsiflexion of the foot) is thought to be associated with the presence of thrombosis. However, Homans’s sign has a very poor predictive value for the presence or absence of deep vein thrombosis, like any other symptom or clinical sign of this disease.
Option C: Hegar’s sign is the softening of the uterine isthmus. Hegar’s sign is a non-sensitive indication of pregnancy in women — its absence does not exclude pregnancy. It pertains to the features of the cervix and the uterine isthmus. It is demonstrated as a softening in the consistency of the uterus, and the uterus and cervix seem to be two separate regions.
Option D: Goodell’s sign (cervical softening) is a probable sign of pregnancy. In medicine, the Goodell sign is an indication of pregnancy. It is a significant softening of the vaginal portion of the cervix from increased vascularization. This vascularization is a result of hypertrophy and engorgement of the vessels below the growing uterus. This sign occurs at approximately four weeks’ gestation.

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