After total thyroidectomy, which finding indicates hypocalcemia requiring assessment?

• A. Circumoral numbness
• B. Weight gain
• C. Confusion
• D. Increased appetite

Answer: (A)

After total thyroidectomy, there’s a real risk of hypocalcemia from damage or removal of the parathyroid glands, which regulate calcium. The earliest and most telling sign of low calcium is circumoral numbness—tingling around the mouth and lips—reflecting increased neuromuscular excitability. This finding prompts an immediate check of serum calcium (and ionized calcium) and prompt management if needed. Other options don’t fit as well: weight gain isn’t a feature of acute hypocalcemia, confusion can occur with severe cases but is less specific, and increased appetite is not related to calcium levels. If circumoral numbness is present, think calcium assessment and treatment as indicated.