A 58-year-old woman presents to her physician because of neck discomfort and difficulty swallowing. She first began to have difficulty with swallowing

Subject
Surgery
System
Endocrine, Diabetes & Metabolism

Kathryn

Member
Jul 29, 2020
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Singapore
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A 58-year-old woman presents to her physician because of neck discomfort and difficulty swallowing. She first began to have difficulty with swallowing solids 2 years ago, but the problem is getting progressively worse. She denies hemoptysis, hematemesis, abdominal pain, or change in bowel habits. She is a nonsmoker and past medical history is significant only for mild hypertension. Her temperature is 36.9°C (98.4°F), heart rate is 72/min, and blood pressure is 132/78 mm Hg. She has an asymmetrically enlarged thyroid gland that is particularly firm on the right, with poorly palpable borders. Laboratory evaluation reveals a free thyroxine level of 4.1 ng/dL and thyroid-stimulating hormone of 5 μU/mL. Based on the results of a radioisotope scan and a fine needle aspiration biopsy, the physician decides to perform surgery. For which of the following is the patient at increased risk postoperatively?
(A) Bone metastases
(B) Hypercalcemia
(C) Hypocalcemia
(D) Hypophosphatemia
(E) Pheochromocytoma
 
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