icandoittoo
Forum Senior
Topics: 20
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Which of the following lab tests should be performed on a serum specimen in the immediate postoperative after a subtotal Thyroidectomy for a follicular neoplasm?
a.-calcitonin
b.-TSH
c.-PTH
d.-Anti-thyroglobulin antibody
e.-Calcium
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| icandoittoo
Forum Senior
Topics: 20
Posts: 73
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No one wants to give a try?
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| me007
Forum Guru
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e.
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| icandoittoo
Forum Senior
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me007, Why not C( PTH)?
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| me007
Forum Guru
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i think bcs
1 - easier
2- PTH level is interesting but pt condition actually depends on electrolite level
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| sfk
Forum Elite
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Posts: 294
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E. because its talking about immediate postop period
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Forum Elite, But Step 2 Newbie....
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| SmokyWaters
Forum Elite
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I am sorry but the question is not well written.. :$
serum calcium lowers after a DAY not immediately
and same goes for PTH...
none of them is part of routine investigations unless there is some indication...
other choices dont match...
I wud go for serum calcium though...
whats the answer 
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| Doc750
transfer:step 3 prison
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C.
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Experience is a hard teacher because she gives the test first, and the lesson afterwards.
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| SmokyWaters
Forum Elite
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umm..
I just read that icandoittoo is askin from me007 but lemme interfere :P
PTH isnt measured in immediate post op period cuz the manipulation of thyroid can do what? yes ... you are right...it will and can alter PTH values...
there is also another problem ...a few like 10% of the patients develop transient hypocalcemia so what I do is ...I check for chvostek and the other sign :P I dunno the spellings...
and if its there...go for ionized calcium levels... hope you know they are difficult to collect...
what I have found in such patients is that they are hypocalcemic after a day and if you arent aware of this complication... you wil be contacted by someone that the patient has STRANGE INFOLODING OF THUMB INTO THE HAND...whic his.... :P say it...
yes its carpopedal spasm... 
hope u got the milk
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| sureshrx
Forum Newbie
Topics: 5
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but its a subtotal thyroidectomy guys.very unlikely to cause hypocalcemia....esp when even in total thyroidectomy u are supposed to preserve the parathyroids.....is it possible that thyroglobulin was missed out in the choices..... it being the tumor marker and all.... just thinking out loud
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| SmokyWaters
Forum Elite
Topics: 6
Posts: 458
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thyroglobulin is also increased in post op period...
secondly... u dunno where the parathyroids are
so if its total/subtotal/near total ...u have to do it...if u got the money...otherwise wait until patient tells u that he is feeling numbness n tingling in his fingers
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| icandoittoo
Forum Senior
Topics: 20
Posts: 73
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The correct answer is E (calcium). Question is from Robbins Review of Pathology.
Guess what,SmokyWaters?
I don t get the point yet .Maybe the following question is a stupid one . But How do u explain the hypocalcemic state?
Is it directly related to the thyroidectomy or injury to parathyroid gland during surgery?
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