Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
10 Cards in this Set
- Front
- Back
|
40 year old woman with calcium of 11.2 (normal 8.5-10.4). She complains of fatigue. Otherwise healthy, exam normal, rerate calcium is 11.1. Albumin 3.9.
A. Phosphorus B. PTH C. Calcitonin D. Prolactin E. PTH-related peptide |
PTH
Calcitonin never goes up to a level that it would affect calcium metabolism (doesn't really change a whole lot) |
|
|
What is most likely cause (most common) of elevated calcium? |
Primary hyperparathyroidism |
|
|
What are the PTH causes of hypercalcemia? |
Primary/tertiary hyperparathyroidism Familial hypocalciuric hypercalcemia Lithium of HCTZ-mediated |
|
|
What is the work up of hypercalcemia |
1. H and P 2. Total serum calcium and albumin 3. PTH |
|
|
Patient diagnosed with hyperparathyroidism. Which of the following statements is true regarding HYPERPARATHYROIDISM?
A. Four gland hyperplasia B. Elevated menin in nucleus C. Mutation in ET oncogene D. Elevated level of cyclin D1 E. Abnormal calcium-sensing receptor distribution in the membrane. |
Elevated level of cyclin D1
If it were parathyroid adenoma (85% of primary hyperthyroidism), then just one gland would have hyperplasia.
|
|
|
What is the best test to determine if patient has FHH? |
Autosomal dominant => so check for elevated calcium in parents. |
|
|
80 year old man with 50 year history of smoking, presents with weight loss, fatigue, polyuria.
Chest x-ray reveals 4 cm right pulmonary mass.
What laboratory pattern will likely by detected?
1. normal calcium or PTH 2. Calcium 11.2, PTH 50 3. Calcium 13.3, PTH <10 4. Calcium 12.1, PTH 100, PTH-related protein elevated |
3. Elevated calcium, low PTH
PTH-related peptide could also be elevated |
|
|
Patient's calcium was 15.0, PTH < 10, serum creatinine 3.0 (acute kidney injury). Patient is confused. BP is 70/40 and heart rate 110 bpm. What is the most appropriate next step in management?
1. Calcitonin injection 2. Diuretic therapy 3. Normal saline injection 4. Low-calcium diet |
Significant dehydration => volume depletion => give normal saline
TREAT LIFE THREATENING FIRST!
|
|
|
60 yo woman in ER with numbness in lips and infers. Discharged 3 days ago after neck surgery. You see well-healing lower neck scar. Tappin her check causes contraction at the corner of her lips. Which is most likely causing symptoms?
1. High PTH 2. Low 25-OH vitamin D 3. Low calcium level 4. Low 24,25 OH-2 Vitamin D concentration 5. High phosphorus level |
Low calcium level
Vitamin D hormones have long half-life (14 days or so), so probably not causing her relatively acute symptoms |
|
|
36 yo roan medullary thyroid carcinoma. Calcitonin is elevated. Multiple masses in neck and chest. Bumps on tongue. BP normal, HR normal. What is correct about patient?
1. She has a mutation in MEN1 gene 2. Her CEA level is low 3. She has hypercalcemia 4. She may have elevated levels of catecholamines 5. Her RET proto-oncogene function is normal
|
MEN 2B => some have pheochromocytomas => elevated catecholamines |
