Question

A 58-year-old woman is found to have persistent hypercalcaemia (adjusted calcium 2.75 mmol/L) with elevated PTH and reduced bone density on DEXA. She is largely asymptomatic but has a history of one renal stone. Which statement best reflects current indications for parathyroidectomy in primary hyperparathyroidism?

Accepted Answer

Surgery is indicated if serum calcium is >0.25 mmol/L above upper limit of normal or if there is nephrolithiasis or osteoporosis

Answer

Surgery is indicated only if the patient is symptomatic

Answer

Surgery is never indicated in asymptomatic patients

Answer

Surgery is indicated only when calcium is >3.5 mmol/L

Answer

Medical therapy with bisphosphonates has replaced surgery in all cases

Practice question