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* Ck Free150 - Endo q- Explanation needed.
 #841826  
  dream250 - 06/17/17 16:50
 
  A 57-year-old man comes to the emergency department because of cramping in his hands and feet and numbness and tingling around his lips and in his fingers; these symptoms occurred intermittently for 6 months but have been progressively severe during the past 2 weeks. He also has had a 13-kg (30-lb) weight loss and bulky, foul-smelling stools that do not flush easily. He has a 10-year history of drinking 8 to 10 beers daily. He has been hospitalized twice for severe abdominal pain 4 and 6 years ago. His pulse is 80/min, and blood pressure is 105/65 mm Hg. He appears cachectic and chronically ill. The abdomen is nontender. Deep tendon reflexes are 4+ bilaterally. Chvostek and Trousseau signs are present. His serum calcium concentration is 6.5 mg/dL. Which of the following is the most likely diagnosis?

(A) Hypomagnesemia
(B) Hypoparathyroidism
(C) Osteomalacia
(D) Vitamin D deficiency

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Got it right. Ans is D.
But why not B?
 
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* Re:Ck Free150 - Endo q- Explanation needed.
#3341268
  cardio69 - 06/17/17 18:12
 
  What suggests in Q history of excess alcohol intake/chronic alcoholics*. All you painted in stem is hypocalcaemia minus respiratory alkalosis and conformation with lab low Ca. blood sample for PTH and D3 should have been drawn in real deal but not required & GI paint history abdominal pain, bulky and foul smelling stool and losing weight ( hyopMg also stand*) but nothing here from lab + history should suggest B. Only washing of vitamin D add to what been preach.  
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* Re:Ck Free150 - Endo q- Explanation needed.
#3341297
  dream250 - 06/18/17 10:33
 
  "Only washing of vitamin D add to what been preach."

I don't get this.
 
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* Re:Ck Free150 - Endo q- Explanation needed.
#3341298
  mah2 - 06/18/17 11:01
 
  Hi cardio,

Thanks for the answer but why not hypoMg ?
 
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* Re:Ck Free150 - Endo q- Explanation needed.
#3341354
  cardio69 - 06/18/17 20:34
 
  Hi @mah2
HypoMg among alcoholic is quite common. You recall alcohol ↓ dietary of it & direct tubular paralysis can lead to ↑ excretion of it. However, less likely from what you been given in stem of Q than Vit D def. Side note; HypoMg in the presence of norm serum Ca usually by ↑ neuromuscular irritability & pic hyprreflexia tremor/tetany/ even convulsions. Remember, Trousseau/Chvostek sign traditionally assoc with hypoCa but it can mirror on hypoMg pat. As Vit D fall in fat soluble vit the best pick from what given & conformation of lab would seal stemp the Vit D as ans.
 
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* Re:Ck Free150 - Endo q- Explanation needed.
#3341358
  dream250 - 06/18/17 23:03
 
  Thank you ...  
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