You are taking "home call" as a surgery resident. You're not really sure what this means until you get called by a patient who says she has "tingling in the lips and fingertips." You glance at your signout which says "s/p total thyroidectomy for thyroid cancer."Challenge: What's your midnight diagnosis?
Image shows a rendering by Max Bro of a thyroidectomy performed by surgeon William Halsted, from www.jhu.edu, shown under Fair Use.
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2 comments:
Hypocalcemia! The parathyroid glands may have been injured or removed during the case.
Thanks, Dr. C :)
right on!
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Home Call
Hypocalcemia as a result of hypoparathyroidism is the most common cause of thyroidectomy. Transient hypoparathyroidism is extremely common, and permanent hypoparathyroidism occurs in ~2% of cases. Treatment is with oral calcium and calcitriol.
Source: UpToDate.
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