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+--- Thread: Chvostek's - guest78 (/showthread.php?tid=477123)
Chvostek's - guest78 - ArchivalUser - 01-14-2010
A 78-year-old woman is evaluated for fatigue, irritability, and depression. She is a resident of a nursing home and her ambulation is limited by a residual right-sided hemiparesis following a stroke 3 years ago. She has a history of type 2 diabetes mellitus, hypertension, and hyperlipidemia. Medications include glipizide, simvastatin, aspirin, lisinopril, furosemide, and amlodipine. Physical examination reveals a positive Chvostek's sign on the right side, dry skin, brittle nails, and coarse hair.
Laboratory Studies
Blood urea nitrogen
18 mg/dL (6.43 mmol/L)
Creatinine
1.2 mg/dL (106.1 µmol/L)
Albumin
3.5 g/dL (35 g/L)
Calcium
7.2 mg/dL (1.8 mmol/L)
Alkaline phosphatase
260 U/L
Which of the following is the most appropriate next test in the evaluation of this patient?
A Parathyroid sestamibi scan
B 25-hydroxyvitamin D
C 1,25-dihydroxyvitamin D3
D Calcitonin
0 - ArchivalUser - 01-14-2010
bbb
0 - ArchivalUser - 01-14-2010
answer ????
0 - ArchivalUser - 01-14-2010
correct. good going.
0 - ArchivalUser - 01-14-2010
kindly post explanations also.
0 - ArchivalUser - 01-14-2010
he has calcium deff.1st thing to change is 25 OH vit D
0 - ArchivalUser - 01-14-2010
nursing home resident ...no proper sunexposer...vit d deficiency....
0 - ArchivalUser - 01-14-2010
bergkamp, here its vit D def due to chronic malnutrition, so 25 OHD should be low. here 1,25 DiOHD could be normal as PTH will be high as an effect of low Ca, so 1,25 diOHD level wont help much.