CSHK Part 2 EMQ Practice Questions - MHKICBSC Part 2 - Clinical Problem Solving EMQ Exam

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A 62-year-old postmenopausal female presents with recurrent nephrolithiasis, fatigue, and diffuse bone pain. Her serum calcium is 2.92 mmol/L (normal: 2.15-2.55 mmol/L), serum phosphate is 0.72 mmol/L (normal: 0.8-1.5 mmol/L), and intact parathyroid hormone (PTH) is elevated at 145 pg/mL (normal: 10-65 pg/mL). A dual-energy X-ray absorptiometry (DEXA) scan shows a T-score of -2.8 at the femoral neck. What is the most sensitive and widely used localizing study to plan a minimally invasive parathyroidectomy?

Technetium-99m sestamibi scintigraphy combined with SPECT/CT High-resolution 4D-CT scan of the neck High-resolution ultrasound of the neck Selective venous sampling for PTH

Correct Answer:

Technetium-99m sestamibi scintigraphy combined with SPECT/CT

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