A 57-year-old man comes to the emergency department for the evaluation of worsening fatigue, urinary frequency, and constipation over the past 5 days. He was recently diagnosed with metastatic bladder cancer and is currently awaiting treatment. He has smoked 1 pack of cigarettes daily for 35 years. Physical examination shows dry mucous membranes and diffuse abdominal tenderness. An ECG shows a shortened QT interval. Which of the following sets of serum findings is most likely in this patient? $$$ Calcium %%% Phosphorus %%% Parathyroid hormone %%% 1,25-dihydroxyvitamin D $$$
A↑ ↓ ↓ ↓
B↑ ↑ ↓ ↑
C↑ ↑ ↑ ↓
D↑ ↓ ↑ ↑
E↓ ↑ ↑ ↓
A 17-year-old boy comes to the physician for a follow-up examination. Two months ago, he suffered a spinal fracture after a fall from the roof. He feels well. His father has multiple endocrine neoplasia type 1. Vital signs are within normal limits. Examination shows no abnormalities. Laboratory studies show: Hemoglobin 13.7 g/dL Serum Creatinine 0.7 mg/dL Proteins Total 7.0 g/dL Albumin 4.1 g/dL Calcium 11.4 mg/dL Phosphorus 5.3 mg/dL Alkaline phosphatase 100 U/L Which of the following is the most likely cause of these findings?
AImmobilization
BParathyroid adenoma
CParaneoplastic syndrome
DSarcoidosis
EPseudohypercalcemia
A 37-year-old female presents to her primary care physician with constipation and abdominal pain. She notes that the pain has been present for several days and is not related to food. She also reports increased urinary frequency without incontinence, as well as increased thirst. She takes no medications, but notes taking vitamin supplements daily. Her vital signs are: BP 130/72 mmHg, HR 82 bpm, T 97.0 degrees F, and RR 12 bpm. Lab studies reveal: Na 139, K 4.1, Cl 104, HCO3 25, Cr 0.9, and Ca 12.4. Further studies show an increased ionized calcium, decreased PTH, and normal phosphate. What is the most likely cause of this patient's symptoms?
AVitamin overdose
BVitamin deficiency
CInherited disorder
DPlasma cell neoplasm
EPrimary endocrine dysfunction
+ 7 more in the PDF
Browse all chapters