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NBME Answers

free120/Block 2/Question#13 (3.6 difficulty score)
A 33-year-old man undergoes a radical ...
Branch of the thyrocervical trunk🔍
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 +0 
submitted by dpineda28(0),

The vignette describes a patient with hypoparathyroidism, likely due to damage to the parathyroid blood supply during thyroidectomy.

The parathyroids are supplied primarily by the inferior thyroid arteries, which branch from the thyrocervical trunk.

Collaterals from the superior thyroid arteries (branches of the external carotids) exist but are supplementary.

Reference: https://www.ncbi.nlm.nih.gov/books/NBK537203/




 -2 
submitted by b1ackcoffee(26),

Calcium is low while PTH is high. It’s primary hyperparathyroidism (not secondary). Ans is branch of IJV.

b1ackcoffee  I got that it must be some vein, I just didn’t know the tributaries. Oh well, anatomy fucks me again! +  
azibird  I believe this would be more likely called a type of pseudohypoparathyroidism. Akin to PTH resistance, the PTH just can't get out to do its thing. Good catch though, I didn't even get what was happening here. +  
azibird  From wikipedia: "Each parathyroid vein drains into the superior, middle and inferior thyroid veins. The superior and middle thyroid veins drain into the internal jugular vein, and the inferior thyroid vein drains into the brachiocephalic vein." https://en.wikipedia.org/wiki/Parathyroid_gland +