a 56-year-old man has a large pulmonary mass, hilar lymphadenopathy, volume depletion, and obturation. In the emergency department, his laboratory test results show a serum calcium 14.8 mg/dL. Phosphorus 3.1 mg/dL, and creatinine 2.1 mg/dL Which of the following is the most appropriate initial management of his hypercalcemia?
سؤال مجاني 5 من 10 اليوم · اشترك وكمّل بدون حد
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الإجابة والشرح
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الإجابة: A. Intravenous normal saline
Severe hypercalcaemia (14.8 mg/dL) with volume depletion and raised creatinine is treated first with IV normal saline. Bisphosphonates and calcitonin are added afterwards. Furosemide is only for volume-overloaded patients and would worsen dehydration here.
ليش كل خيار صح أو غلط
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A
ليش صح
Hydration with IV normal saline is the initial treatment of hypercalcemia (0.9% NaCl IV); this patient is also volume depleted.
✓ Endocrine ✳️.pdf · p. 16 -
B
ليش غلط
Calcitonin is a medication added after hydration, for severe cases (preferred in cancer), so it is not the initial step.
✓ Endocrine ✳️.pdf · p. 16 -
C
ليش غلط
Loop diuretics are for overloaded patients only; this patient is volume depleted and needs fluids first.
✓ Calcium and Parathyroid.pdf · p. 55 -
D
ليش غلط
IV bisphosphonates (e.g. pamidronate) are for severe cases after hydration, which is the initial treatment.
✓ Endocrine ✳️.pdf · p. 16 -
E
ليش غلط
Glucocorticoids work in vitamin D-related causes and myeloma, and are ineffective in most other forms of hypercalcemia; his picture (large lung mass) is not one of those.
✓ Step_Up_To_Medicine_6th,_2024_Electrolytes_Na,K_Imbalance.pdf · p. 9
- المصدر
- Endocrine ✳️.pdf · p. 16
Calcium and Parathyroid.pdf · p. 55 - المحاضرة
- Parathyroid & Calcium Disorders · Endocrinology · Module B
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- Endo bank