a 55-year-old man presents to the Emergency department complaining of increased thirst, abdominal pain and polyuria. His workup reveals elevated adjusted calcium Which of the following is the most appropriate test to find out the cause of his hypercalcemia?
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الإجابة: C. Parathyroid hormone
Once hypercalcaemia is confirmed, the key test for the cause is PTH. A high or normal PTH means parathyroid-mediated disease. A low PTH leads on to PTHrP, vitamin D metabolites and SPEP. So PTHrP, SPEP and imaging come after PTH, not before.
ليش كل خيار صح أو غلط
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A
ليش غلط
SPEP/UPEP/free light chains are the last branch (when PTHrP and vitamin D are not elevated), looking for multiple myeloma; PTH comes first.
✓ Calcium and Parathyroid.pdf · p. 49 -
C
ليش صح
The approach to hypercalcemia (after albumin correction) starts with PTH: high or normal means parathyroid disease; low sends you on to PTHrP and vitamin D.
✓ Calcium and Parathyroid.pdf · p. 49 -
D
ليش غلط
A bone scan or survey only identifies lytic lesions; PTH is the test that sorts the cause (elevated in primary hyperparathyroidism, low in occult malignancy).
✓ Step_Up_To_Medicine_6th,_2024_Electrolytes_Na,K_Imbalance.pdf · p. 9 -
E
ليش غلط
PTHrP is checked only if PTH is low (a high PTHrP then leads to malignancy work-up), so it comes after PTH.
✓ Calcium and Parathyroid.pdf · p. 49
- المصدر
- Calcium and Parathyroid.pdf · p. 49
Endocrine ✳️.pdf · p. 16 - المحاضرة
- Parathyroid & Calcium Disorders · Endocrinology · Module B
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- Endo bank