{"id":1599,"date":"2022-04-13T15:31:00","date_gmt":"2022-04-13T15:31:00","guid":{"rendered":"https:\/\/www.osmosis.org\/blog\/?p=1599"},"modified":"2025-10-01T11:40:31","modified_gmt":"2025-10-01T19:40:31","slug":"usmle-step-1-question-of-the-day-severe-lower-extremity-cramping","status":"publish","type":"post","link":"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-severe-lower-extremity-cramping","title":{"rendered":"USMLE\u00ae Step 1 Question of the Day: Severe Lower-Extremity Cramping"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_86 ez-toc-wrap-center counter-hierarchy ez-toc-counter ez-toc-custom ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">In This Article<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-severe-lower-extremity-cramping\/#The_correct_answer_to_todays_USMLE%C2%AE_Step_1_Question_is%E2%80%A6\" >The correct answer to today&#8217;s USMLE\u00ae Step 1 Question is&#8230;<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-severe-lower-extremity-cramping\/#B_QT-interval_prolongation\" >B. QT-interval prolongation<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-severe-lower-extremity-cramping\/#Incorrect_answer_explanations\" >Incorrect answer explanations<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-severe-lower-extremity-cramping\/#A_Flattened_T_waves\" >A. Flattened T waves<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-severe-lower-extremity-cramping\/#C_Positive_deflection_at_the_J_point\" >C. Positive deflection at the J point<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-severe-lower-extremity-cramping\/#D_Peaked_T_waves\" >D. Peaked T waves<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-severe-lower-extremity-cramping\/#E_ST_segment_depression\" >E. ST segment depression<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-severe-lower-extremity-cramping\/#Main_Explanation\" >Main Explanation<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-severe-lower-extremity-cramping\/#Major_Takeaway\" >Major Takeaway<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-10\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-severe-lower-extremity-cramping\/#References\" >References<\/a><\/li><\/ul><\/nav><\/div>\n\n<p class=\"wp-block-paragraph\"><strong><em>This week, we are sharing another USMLE\u00ae Step 1-style practice question to test your knowledge of medical topics.&nbsp;<\/em><\/strong><strong><em>Today&#8217;s case focuses on a 52-year-old man with severe lower-extremity cramping. The cramping appeared after recent thyroid surgery.&nbsp;<\/em><\/strong><strong><em>Can you figure it out?<\/em><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A 52-year-old man comes to the emergency room because of severe lower-extremity cramping. The symptoms started three days ago. Past medical history is notable for hypertension, and he recently underwent surgery for a \u201cthyroid problem.\u201d He currently takes propranolol. Temperature is 37.4\u00b0C (99.3\u00b0F), pulse is 80\/min, respirations are 18\/min and blood pressure is 141\/78 mmHg. While the blood pressure is being measured in the left arm, spasms are noted in the patient\u2019s left hand. Cardiac, pulmonary, and abdominal exams are noncontributory. Blood tests and an electrocardiogram (ECG) are ordered. Which of the following findings will most likely be observed on the patient\u2019s ECG?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>A. Flattened T waves<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>B. QT-interval prolongation<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>C. Positive deflection at the J point<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>D. Peaked T waves<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>E. ST segment depression<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Scroll down to find the answer!<\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-rich is-provider-embed-handler wp-block-embed-embed-handler wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"Everybody loves Osmosis.org\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/kizbJZ9cdLg?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><em><a href=\"https:\/\/www.osmosis.org\/plans\" target=\"_blank\" rel=\"noreferrer noopener\"><u><em><strong>\u2192 Reinforce your understanding with more self-assessment items on Osmosis<\/strong><\/em><\/u><\/a><\/em><\/strong><\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"The_correct_answer_to_todays_USMLE%C2%AE_Step_1_Question_is%E2%80%A6\"><\/span>The correct answer to today&#8217;s USMLE\u00ae Step 1 Question is&#8230;<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"B_QT-interval_prolongation\"><\/span>B. QT-interval prolongation<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Before we get to the&nbsp;<strong>Main Explanation<\/strong>, let&#8217;s look at the incorrect answer explanations. Skip to the bottom if you want to see the correct answer right away!<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Incorrect_answer_explanations\"><\/span>Incorrect answer explanations<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The incorrect answers to today&#8217;s USMLE\u00ae Step 1 Question are&#8230;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"A_Flattened_T_waves\"><\/span>A. Flattened T waves<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:&nbsp;<\/strong>Flattened T waves are observed in patients with hypokalemia. Hypokalemia can also present with muscle spasms and cramping. However, the patient\u2019s history of recent thyroid surgery is concerning for hypocalcemia, since the operation may damage or remove the&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Hyperparathyroidism:_Nursing\" target=\"_blank\" rel=\"noreferrer noopener\">parathyroid glands<\/a>. Hypocalcemia does not typically present with flattened T waves.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"C_Positive_deflection_at_the_J_point\"><\/span>C. Positive deflection at the J point<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:<\/strong>&nbsp;An Osborn wave (a positive deflection at the J point) may be observed in patients with&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Hypercalcemia\" target=\"_blank\" rel=\"noreferrer noopener\">hypercalcemia<\/a>. Hypercalcemia can present with bone pain, constipation, kidney stones, and altered mental status. However, the patient\u2019s history of recent thyroid surgery is more concerning for hypocalcemia.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"D_Peaked_T_waves\"><\/span>D. Peaked T waves<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:<\/strong>&nbsp;Peaked T waves are observed in patients with&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Hyperkalemia\" target=\"_blank\" rel=\"noreferrer noopener\">hyperkalemia<\/a>. The condition can present with arrhythmias and muscle weakness. However, it would be atypical for hyperkalemia to present with muscle spasms, and there are no conditions in the patient\u2019s history (e.g., kidney disease, hypoaldosteronism, etc.) that would increase the risk of hyperkalemia.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"E_ST_segment_depression\"><\/span>E. ST segment depression<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:<\/strong>&nbsp;ST segment depression can be seen in conditions such as subendocardial ischemia, digoxin toxicity or&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Hypokalemia\" target=\"_blank\" rel=\"noreferrer noopener\">hypokalemia<\/a>. However, these conditions would not present with muscle spasms and cramps as observed in this patient.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><a href=\"https:\/\/www.osmosis.org\/plans\/md\" target=\"_blank\" rel=\"noreferrer noopener\"><img loading=\"lazy\" decoding=\"async\" width=\"700\" height=\"250\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/2024-09-09T133739.007.png?w=700\" alt=\"\" class=\"wp-image-1457\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/2024-09-09T133739.007.png 700w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/2024-09-09T133739.007.png?resize=300,107 300w\" sizes=\"auto, (max-width: 700px) 100vw, 700px\" \/><\/a><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Main_Explanation\"><\/span><strong>Main Explanation<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">This patient with severe lower extremity&nbsp;<strong>cramping<\/strong>&nbsp;after a<strong>&nbsp;recent thyroid surgery<\/strong>&nbsp;is most likely having&nbsp;<strong><a href=\"https:\/\/www.osmosis.org\/learn\/Hypocalcemia\" target=\"_blank\" rel=\"noreferrer noopener\">hypocalcemia<\/a><\/strong>&nbsp;secondary to<strong>&nbsp;iatrogenic hypoparathyroidism<\/strong>. It is the most common cause of<a href=\"https:\/\/www.osmosis.org\/learn\/Hypoparathyroidism\" target=\"_blank\" rel=\"noreferrer noopener\">&nbsp;hypoparathyroidism<\/a>, as thyroid surgery often leads to the damage and\/or removal of the parathyroid glands<strong>.<\/strong>&nbsp;Another common cause is autoimmune destruction of the parathyroid glands.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Hypoparathyroidism causes&nbsp;<strong><a href=\"https:\/\/www.osmosis.org\/learn\/Hypocalcemia\" target=\"_blank\" rel=\"noreferrer noopener\">hypocalcemia<\/a><\/strong>&nbsp;and&nbsp;<strong><a href=\"https:\/\/www.osmosis.org\/learn\/Hyperphosphatemia\" target=\"_blank\" rel=\"noreferrer noopener\">hyperphosphatemia<\/a><\/strong><strong>.<\/strong>&nbsp;These electrolyte derangements make neurons more excitable, which can trigger tetany and&nbsp;<strong>muscle spasms<\/strong>. Other findings include paresthesias, the&nbsp;<strong>Chvostek sign<\/strong>, which is when facial muscles twitch after the facial nerve is lightly tapped below the zygomatic process, and the&nbsp;<strong>Trousseau sign<\/strong>, which is when tightening of a blood pressure cuff causes muscle spasm in the wrist and hand (as seen in this patient). If the hypocalcemia and hyperphosphatemia are severe, life-threatening complications like<strong>&nbsp;seizures<\/strong>&nbsp;and&nbsp;<strong>cardiac arrhythmias<\/strong>&nbsp;can occur.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Diagnosis is based on blood tests for&nbsp;<strong><a href=\"https:\/\/www.osmosis.org\/learn\/Parathyroid_hormone\" target=\"_blank\" rel=\"noreferrer noopener\">parathyroid hormone<\/a><\/strong><strong>, calcium,&nbsp;<\/strong><strong><a href=\"https:\/\/www.osmosis.org\/learn\/Vitamin_D\" target=\"_blank\" rel=\"noreferrer noopener\">vitamin D<\/a><\/strong><strong>, albumin, phosphorus, and magnesium.<\/strong>&nbsp;Also, an&nbsp;<strong><a href=\"https:\/\/www.osmosis.org\/learn\/ECG_basics\" target=\"_blank\" rel=\"noreferrer noopener\">electrocardiogram<\/a><\/strong>&nbsp;might have changes such as a&nbsp;<strong>prolonged QT&nbsp;<\/strong>(see EKG below),<strong>&nbsp;prolonged ST segment<\/strong>, and<strong>&nbsp;arrhythmias<\/strong>, like&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Long_QT_syndrome_and_Torsade_de_pointes\" target=\"_blank\" rel=\"noreferrer noopener\">torsade de pointes<\/a>&nbsp;and&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Atrial_fibrillation\" target=\"_blank\" rel=\"noreferrer noopener\">atrial fibrillation<\/a>.<\/p>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\"><strong>EKG with prolonged QT interval<\/strong><\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"348\" height=\"191\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/ekg.png\" alt=\"\" class=\"wp-image-1601\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/ekg.png 348w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/ekg.png?resize=300,165 300w\" sizes=\"auto, (max-width: 348px) 100vw, 348px\" \/><\/figure>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\">Image reproduced from&nbsp;<a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Combined_hyperkalemia_and_hypocalcemia.png\" target=\"_blank\" rel=\"noreferrer noopener\">Wikimedia Commons<\/a><\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Major_Takeaway\"><\/span><strong>Major Takeaway<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Iatrogenic hypoparathyroidism<\/strong>&nbsp;is the most common cause of hypoparathyroidism. The condition causes&nbsp;<strong>hypocalcemia<\/strong>&nbsp;and presents with symptoms including&nbsp;<strong>muscle spasms, cramps, seizures, and arrhythmias.<\/strong>&nbsp;ECG may show&nbsp;<strong>prolonged QT<\/strong>,<strong>&nbsp;prolonged ST segment, and arrhythmias<\/strong>, like torsade de pointes and atrial fibrillation.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"References\"><\/span><strong>References<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Goyal, A., Singh, S. (2019) Hypocalcemia.&nbsp;<em>StatPearls [Internet]<\/em>. Web Address:&nbsp;<a href=\"https:\/\/www.statpearls.com\/kb\/viewarticle\/23258\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.statpearls.com\/kb\/viewarticle\/23258<\/a>.<br>Mannstadt, M., Bilezikian, J.P., Thakker, R.V., Hannan, F.M., Clarke, B.L., Rejnmark, L., Mitchell, D.M., Vokes, T.J., Winer, K.K., Shoback, D.M. (2017) Hypoparathyroidism.&nbsp;<em>Nature Reviews Disease Primer<\/em>. 3, 17055.&nbsp;<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/28857066\/\" target=\"_blank\" rel=\"noreferrer noopener\">Doi: 10.1038\/nrdp.2017.55.<\/a><\/p>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\"><em><strong>_________________________<\/strong><br><br><strong>Want more USMLE\u00ae Step 1 practice questions? Try Osmosis today! Access your&nbsp;<em><strong><a href=\"https:\/\/www.osmosis.org\/login?type=create\" target=\"_blank\" rel=\"noreferrer noopener\">free trial<\/a><\/strong><\/em>&nbsp;and find out why millions of current and future clinicians and caregivers love learning with us.<\/strong><\/em><\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><a href=\"https:\/\/www.osmosis.org\/ultimate-guide\/usmle-step-1\"><img loading=\"lazy\" decoding=\"async\" width=\"700\" height=\"250\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/the-ultimate-guide-usmle-step-1-banner.png?w=700\" alt=\"The Ultimate Guide to the USMLE Step 1: Everything you need to know\" class=\"wp-image-760\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/the-ultimate-guide-usmle-step-1-banner.png 700w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/the-ultimate-guide-usmle-step-1-banner.png?resize=300,107 300w\" sizes=\"auto, (max-width: 700px) 100vw, 700px\" \/><\/a><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\"><br><em><em><sub>The United States Medical Licensing Examination (USMLE\u00ae) is a joint program of the Federation of State Medical Boards (FSMB\u00ae) and National Board of Medical Examiners (NBME\u00ae). Osmosis is not affiliated with NBME nor FSMB.&nbsp;<\/sub><\/em><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>This week, we are sharing another USMLE\u00ae Step 1-style practice question to test your knowledge of medical topics.&nbsp;Today&#8217;s case focuses on a 52-year-old man with severe lower-extremity cramping. The cramping appeared after recent thyroid surgery.&nbsp;Can you figure it out? A 52-year-old man comes to the emergency room because of severe lower-extremity cramping. The symptoms started [&hellip;]<\/p>\n","protected":false},"author":202,"featured_media":1600,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_post_was_ever_published":false},"categories":[27,20,1369,44],"tags":[],"class_list":["post-1599","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medicine","category-exam-prep","category-step-1-questions","category-step-1"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.6 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>USMLE\u00ae Step 1 Question of the Day: Severe Lower-Extremity Cramping - Osmosis Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-severe-lower-extremity-cramping\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"USMLE\u00ae Step 1 Question of the Day: Severe Lower-Extremity Cramping - Osmosis Blog\" \/>\n<meta property=\"og:description\" content=\"This week, we are sharing another USMLE\u00ae Step 1-style practice question to test your knowledge of medical topics.&nbsp;Today&#8217;s case focuses on a 52-year-old man with severe lower-extremity cramping. The cramping appeared after recent thyroid surgery.&nbsp;Can you figure it out? A 52-year-old man comes to the emergency room because of severe lower-extremity cramping. 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When you inspect his leg, you\u2026","rel":"","context":"In &quot;Allopathic Medicine (MD)&quot;","block_context":{"text":"Allopathic Medicine (MD)","link":"https:\/\/www.osmosis.org\/blog\/category\/medicine"},"img":{"alt_text":"USMLE\u00ae Step 1 Question of the Day: Right Leg Pain","src":"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/2024-09-12T220808.528.webp","width":350,"height":200,"srcset":"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/2024-09-12T220808.528.webp 1x, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/2024-09-12T220808.528.webp 1.5x, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/2024-09-12T220808.528.webp 2x, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/2024-09-12T220808.528.webp 3x"},"classes":[]},{"id":1187,"url":"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-diverticulum-formation","url_meta":{"origin":1599,"position":5},"title":"USMLE\u00ae Step 1 Question of the Day: Diverticulum Formation","author":"Marina Horiates Kerekes, MD &amp; Team","date":"October 6, 2021","format":false,"excerpt":"Each week, Osmosis shares a USMLE\u00ae Step 1-style practice question to test your knowledge of medical topics. 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