Breast and endocrine surgery: intraoperative PTH monitoring: 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.

Try it

General Surgery · Breast and endocrine surgery: intraoperative PTH monitoring

Sample item

A surgeon performing a focused parathyroidectomy uses the Miami criterion for intraoperative PTH assay. Which result indicates a successful operation?

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

The answer and the reasoning

A. Fall of over 50 percent from the highest baseline at 10 minutes after excision

Parathyroid hormone has a half-life of a few minutes. By the Miami criterion, a fall of more than 50 percent from the highest pre-excision value, 10 minutes after the gland is removed, predicts cure. If it does not fall, more disease should be sought.

Option by option

  • A. Fall of over 50 percent from the highest baseline at 10 minutes after excision (correct)

    Correct. This is the stated Miami criterion for cure.

  • B. Any fall in PTH within 10 minutes after excision

    A small fall may occur even when a second hyperfunctioning gland remains.

  • C. Normal serum calcium five minutes after excision

    Serum calcium changes over hours to days, not minutes.

  • D. Fall of over 20 percent at 30 minutes after excision

    A modest fall at a later time is not the criterion and would risk missing multigland disease.

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, Fall of over 50 percent from the highest baseline at 10 minutes after excision. Parathyroid hormone has a half-life of a few minutes.

Why is "Any fall in PTH within 10 minutes after excision" not the answer?

A small fall may occur even when a second hyperfunctioning gland remains.

Why is "Normal serum calcium five minutes after excision" not the answer?

Serum calcium changes over hours to days, not minutes.

Why is "Fall of over 20 percent at 30 minutes after excision" not the answer?

A modest fall at a later time is not the criterion and would risk missing multigland disease.

What concept does this question test?

It tests Breast and endocrine surgery: intraoperative PTH monitoring in General Surgery. By the Miami criterion, a fall of more than 50 percent from the highest pre-excision value, 10 minutes after the gland is removed, predicts cure. If it does not fall, more disease should be sought.

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 Breast and endocrine surgery: intraoperative PTH monitoring?

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.