Endocrine surgery: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Endocrine surgery

Sample item

A patient with severe primary hyperparathyroidism and osteitis fibrosa cystica undergoes successful parathyroidectomy. On postoperative day 3 he has perioral numbness, carpopedal spasm, and serum calcium, phosphate and magnesium are all low, with PTH normal. What is the most likely cause?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Hungry bone syndrome

Hungry bone syndrome follows removal of a hyperfunctioning parathyroid gland when PTH suddenly falls and bone avidly takes up calcium, phosphate and magnesium. It is more likely in severe bone disease, and PTH is normal or high, unlike hypoparathyroidism. Treatment is high-dose calcium with calcitriol.

Option by option

  • A. Hungry bone syndrome (correct)

    Correct. Low phosphate and magnesium with normal PTH marks rapid bone remineralisation.

  • B. Pseudohypoparathyroidism

    Pseudohypoparathyroidism is hereditary end-organ resistance with high PTH, and it is unrelated to surgery.

  • C. Vitamin D toxicity

    Vitamin D toxicity causes hypercalcaemia.

  • D. Permanent hypoparathyroidism from gland removal

    Hypoparathyroidism would give low calcium with high phosphate and low PTH.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Surgery questions

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is A, Hungry bone syndrome. Hungry bone syndrome follows removal of a hyperfunctioning parathyroid gland when PTH suddenly falls and bone avidly takes up calcium, phosphate and magnesium.

Why is "Pseudohypoparathyroidism" not the answer?

Pseudohypoparathyroidism is hereditary end-organ resistance with high PTH, and it is unrelated to surgery.

Why is "Vitamin D toxicity" not the answer?

Vitamin D toxicity causes hypercalcaemia.

Why is "Permanent hypoparathyroidism from gland removal" not the answer?

Hypoparathyroidism would give low calcium with high phosphate and low PTH.

What concept does this question test?

It tests Endocrine surgery in General Surgery. It is more likely in severe bone disease, and PTH is normal or high, unlike hypoparathyroidism. Treatment is high-dose calcium with calcitriol.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Endocrine surgery?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.