Primary Hyperparathyroidism — Flashcards

Flashcard 1: To prove the possibility of parathyroid graft hyperplasia, the ratio of the PTH levels should be greater than _____ on Casanova test

Answer: 2:1

Extra: The **Casanova test** is used to differentiate between recurrence of hyperparathyroidism due to **parathyroid graft hyperplasia** (autotransplanted to the forearm) versus a **missed gland** in the neck. - **Procedure**: PTH levels are measured in both arms. A blood pressure cuff is used to induce ischemia in the arm containing the graft. - **Interpretation**: A ratio of PTH levels (graft arm vs. non-graft arm) **> 2:1** indicates that the recurrence is due to the graft. If the ratio is < 1, the source is likely in the neck.

Flashcard 2: Drop of PTH to _____ the maximum value at 10 min postresection is considered an adequate resection in a parathyroid adenoma by the Miami criteria

Answer: less than half

Flashcard 3: The most common site of ectopic parathyroid gland in recurrent or persistent hyperparathyroidism is _____

Answer: paraoesophageal

Flashcard 4: Parathyroid insufficiency post thyroidectomy presents usually _____ post-op

Answer: 2-5 days (duration)

Flashcard 5: If the localisation for an ectopic parathyroid is negative and Casanova test is also negative the next best step in persistent PTH would be _____

Answer: medical management

Flashcard 6: If there is no drop in PTH level, post parathyroidectomy, then a multi-gland disease is suspected and the surgery is converted to a _____ exploration.

Answer: bilateral neck

Flashcard 7: The following resection is done in a _____thyroidectomy

Answer: hemi

Flashcard 8: The following resection is done in a _____thyroidectomy

Answer: subtotal

Flashcard 9: The following resection is done in a _____thyroidectomy

Answer: near total

Flashcard 10: _____ retractor is a self-retaining retractor used in thyroid surgery

Answer: Joll