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NBME FORM 2 q 6 - ck4me - Printable Version

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NBME FORM 2 q 6 - ck4me - ArchivalUser - 06-07-2008

17. A 67-year-old woman comes for a routine health maintenance examination. She drinks 1 ounce of alcohol daily. Her blood pressure is 138/62 mm Hg, pulse is 76/min and regular, and respirations are 14/min. The lungs are clear to auscultation. The remainder of the examination shows no abnormalities. Laboratory studies show:

Hemoglobin
12.8 g/dL
Serum

Ca2+
11.9 mg/dL
Creatinine
0.8 mg/dL
Phosphorus
2.8 mg/dL
Total protein
6.5 g/dL
Albumin
4.2 g/dL
Ionized calcium
5.8 mg/dL (N=4.5“5.1)

Which of the following is the most appropriate next step in management?

A
) Measurement of serum alkaline phosphatase activity

B
) Measurement of serum parathyroid hormone level

C
) Measurement of serum vitamin D level

D
) Serum and urine protein electrophoresis

E
) X-ray film of the chest

F
) Skeletal survey

G
) Bone scan


0 - ArchivalUser - 06-07-2008

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