Rosh Internal Medicine Boost Practice Exam

Which condition would not typically cause carpal spasms when blood pressure is taken?

1. Hyperparathyroidism

2. Hypoparathyroidism

3. Hypophosphatemia

4. Hypothyroidism

The correct answer is: Hyperparathyroidism

When considering the causes of carpal spasms, it is important to focus on conditions that influence calcium levels and neuromuscular excitability. Hypoparathyroidism is marked by low levels of parathyroid hormone, leading to hypocalcemia, which can cause increased neuromuscular excitability and result in carpal spasms, especially when blood pressure is taken. Hypophosphatemia can also lead to muscle weakness and spasms due to alterations in electrolytes, particularly when phosphorus levels are low. This condition can further contribute to neuromuscular irritability. On the other hand, hypothyroidism generally does not influence calcium homeostasis in a way that produces carpal spasms. This condition is characterized by a decrease in metabolic activity and does not typically lead to the neuromuscular symptoms seen in conditions like hypoparathyroidism or hypophosphatemia. Hyperparathyroidism, characterized by increased levels of parathyroid hormone, tends to raise serum calcium levels, which usually reduces neuromuscular excitability and minimizes the risk of spasms. Therefore, hyperparathyroidism is the condition that would not typically cause carpal spasms when blood pressure is taken, as it results in elevated calcium levels