A 56-year-old woman has fatigue, constipation, bone pain and recurrent kidney stones. Labs: Ca 12.1 mg/dL (8.5–10.5), phosphate 2.2 (low), PTH elevated, 25-OH vitamin D normal, creatinine 1.1, urinary calcium high. What is the most likely diagnosis?
سؤال مجاني 1 من 10 اليوم · اشترك وكمّل بدون حد
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الإجابة والشرح
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الإجابة: B. Primary hyperparathyroidism
High calcium + low phosphate + high PTH + high urinary calcium is primary hyperparathyroidism (stones, bones, constipation). FHH has the same serum picture but low urinary calcium, so the high urinary calcium rules it out. Vitamin D intoxication and milk-alkali syndrome suppress PTH.
ليش كل خيار صح أو غلط
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A
ليش غلط
FHH also has high PTH and high calcium but low urinary calcium; this patient's urinary calcium is high.
✓ Calcium and Parathyroid.pdf · p. 49 -
B
ليش صح
With high PTH, high urinary calcium points to hyperparathyroidism (low urinary calcium would mean FHH).
✓ Calcium and Parathyroid.pdf · p. 49 -
C
ليش غلط
Vitamin D intoxication sits in the low-PTH branch of the hypercalcemia approach; her PTH is elevated.
✓ Calcium and Parathyroid.pdf · p. 49
- المصدر
- Calcium and Parathyroid.pdf · p. 49
Step Up To Medicine 6th Edition 2024(Parthyroid).pdf · p. 4 - المحاضرة
- Parathyroid & Calcium Disorders · Endocrinology · Module B
- ظهر في
- MED42 Compre B