Afghanistan Medical Exit Exam

Practice session

A 30-year-old female presents with acute muscle cramps, digital paresthesias, and perioral numbness following a total thyroidectomy performed 24 hours ago. On examination, inflating a blood pressure cuff on the upper arm above systolic pressure for 3 minutes elicits painful carpal spasm (Trousseau sign), and tapping over the facial nerve in front of the ear produces ipsilateral facial muscle twitching (Chvostek sign). An ECG shows QT prolongation. What electrolyte abnormality is present?

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