Question

A 32 y/o s/p thyroidectomy presents c/o frequent panic attack, progressive cognitive inefficiency, perceptual disturbances, severe muscle cramps, and carpopedal spasm. PE shows alopecia and absent DTR. DX?

Answer 1

The patient's symptoms and physical examination findings are consistent with a diagnosis of hypoparathyroidism, which can result from the accidental removal or autoimmune destruction of the parathyroid gland during thyroid surgery.

Step-by-step explanation:

The symptoms described by the patient, such as frequent panic attacks, cognitive inefficiency, and muscle cramps, along with the physical examination findings of alopecia and absent deep tendon reflexes, suggest a diagnosis of hypoparathyroidism. This condition can occur as a result of accidental removal or autoimmune destruction of the parathyroid gland during thyroid surgery, leading to low levels of parathyroid hormone (PTH) and hypocalcemia. The neuro-muscular irritability and carpopedal spasm experienced by the patient are characteristic features of hypoparathyroidism.