Surgery · Thyroid and Parathyroid Surgery

A 55-year-old man with primary hyperparathyroidism undergoes focused parathyroidectomy for a single adenoma. Intraoperative PTH is measured. According to the Miami criterion, what percentage drop from the pre-excision baseline at 10 minutes confirms surgical cure?

  • A 90%
  • B 70%
  • C 50%
  • D 30%
Correct answer: C. 50%

Explanation

The Miami criterion defines a surgical cure as a drop of 50% or more in intact PTH from the highest pre-excision level at 10 minutes after gland removal. This criterion has a sensitivity and specificity exceeding 95% for predicting cure. The Halle criterion uses a drop below 35 pg/mL at 15 minutes.

Reference: Schwartz's Principles of Surgery, 11th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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