AIPGMEE 2016 MCQ Surgery

All of the following have been associated with an increased risk for hungry bone syndrome after parathyroidectomy except:
A. Graves disease
B. Tertiary hyperparathyroidism
C. Preoperative PTH level
D. Age
E. Large single adenomas

COMMENTS: “Hungry bone syndrome” is characterized by
postparathyroidectomy hypocalcemia and hypophosphatemia.
Patients most at risk are those with four-gland hyperplasia from
secondary or tertiary hyperparathyroidism. The postoperative
calcium level in these patients can drop critically low and necessitate
intravenous calcium supplementation. During this period
both serum calcium and phosphate levels must be monitored
closely. In some patients it can take more than 4 to 5 days for serum
calcium and phosphate levels to stabilize. Other patients shown to
have increased risk for this condition are those who are older or
have concomitant thyrotoxicosis or a large single adenoma. The
preoperative PTH level has not been found to be an independent
predictor of whether “hungry bone syndrome” will develop
postoperatively.
A N S W E R : C