Head and neck tumours: hungry bone syndrome: practice question

A ENT 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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ENT · Head and neck tumours: hungry bone syndrome

Sample item

A 55-year-old with long-standing severe primary hyperparathyroidism and a very high alkaline phosphatase undergoes parathyroidectomy. On day 3 she has perioral tingling and carpopedal spasm. Calcium, phosphate and magnesium are low, and PTH is normal. What is the cause?

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

The answer and the reasoning

B. Hungry bone syndrome

After removal of an adenoma in severe bone disease, calcium, phosphate and magnesium are rapidly taken up by the demineralised skeleton (hungry bone syndrome), with low calcium despite normal or high PTH. Hypoparathyroidism gives low calcium with high phosphate and low PTH.

Option by option

  • A. Hypoparathyroidism from devascularised remnant glands

    Hypoparathyroidism from devascularised glands has low PTH and high phosphate.

  • B. Hungry bone syndrome (correct)

    Correct. Bone uptake of calcium, phosphate and magnesium with preserved PTH defines hungry bone syndrome.

  • C. Recurrent laryngeal nerve injury causing laryngospasm

    Recurrent laryngeal nerve injury causes hoarseness or stridor, not tetany with low calcium.

  • D. Vitamin D toxicity

    Vitamin D toxicity raises calcium rather than lowering it.

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 ENT questions

Questions about this ENT question

What is the answer to this ENT question?

The best answer is B, Hungry bone syndrome. After removal of an adenoma in severe bone disease, calcium, phosphate and magnesium are rapidly taken up by the demineralised skeleton (hungry bone syndrome), with low calcium despite normal or high PTH.

Why is "Hypoparathyroidism from devascularised remnant glands" not the answer?

Hypoparathyroidism from devascularised glands has low PTH and high phosphate.

Why is "Recurrent laryngeal nerve injury causing laryngospasm" not the answer?

Recurrent laryngeal nerve injury causes hoarseness or stridor, not tetany with low calcium.

Why is "Vitamin D toxicity" not the answer?

Vitamin D toxicity raises calcium rather than lowering it.

What concept does this question test?

It tests Head and neck tumours: hungry bone syndrome in ENT. Hypoparathyroidism gives low calcium with high phosphate and low PTH.

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 Head and neck tumours: hungry bone syndrome?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT 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.