Rosh Emergency Medicine Practice Test

The presence of both Chvostek sign and Trousseau sign during a physical examination is indicative of a risk factor for hypocalcemia. Chvostek sign is elicited by tapping on the facial nerve in front of the ear and observing for facial twitching or spasms. This reaction indicates neuromuscular excitability due to low calcium levels, which is a hallmark of hypocalcemia. Trousseau sign is observed by inflating a blood pressure cuff around the upper arm to a level above systolic pressure for a few minutes. If hypocalcemia is present, this may trigger carpopedal spasms (spasms of the hand and forearm), further demonstrating an underlying neuromuscular irritability associated with decreased calcium levels. Both signs are significant as they serve as clinical indicators that suggest the neuromuscular system is affected by low calcium, thus representing a risk for hypocalcemia.