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+--- Thread: Endo 14 - meduploader (/showthread.php?tid=602693)
Endo 14 - meduploader - ArchivalUser - 07-29-2011
A 75-year-old woman recently had a fractured hip. She has a history of hypertension and hypothyroidism, and has not been taking any medication for the last year. She lives alone and seldom leaves her house. She has a scanty diet and does not consume dairy products. She does not smoke cigarettes or drink alcohol. Her blood pressure is 170/95 mm Hg. She has a small, firm goiter and diffuse muscle weakness.
Laboratory Studies
Serum calcium
8.6 mg/dL
Serum phosphorus
2.4 mg/dL
Serum creatinine
0.8 mg/dL
Serum alkaline phosphatase
188 U/L
Serum thyroid-stimulating hormone
21 μU/mL
Which of the following tests would be most helpful in determining the cause of this patient’s skeletal disease?
( A ) Bone biopsy
( B ) Serum 25(OH) vitamin D
( C ) Serum 1,25(OH) 2 vitamin D
( D ) Serum free thyroxine
( E ) Serum protein electrophoresis
0 - ArchivalUser - 07-29-2011
( B ) Serum 25(OH) vitamin D
0 - ArchivalUser - 07-29-2011
b............both serum calcium and phosphate are low.......
0 - ArchivalUser - 07-29-2011
B ) Serum 25(OH) vitamin D
0 - ArchivalUser - 07-30-2011
B........
meduploader.....thanks
could any one write a little explanation for this qs please ??
0 - ArchivalUser - 07-30-2011
pt stays at home, less exposure to sunlight and in labs low calcium and phosphorus and high PTH more likely to Vit D def.the next step is to look for low 25(OH) levels
0 - ArchivalUser - 07-30-2011
krishkamz........thanks
if i remember well,thyroxine help absorption in the gut
is hypothyroidism making a mess here too ??
0 - ArchivalUser - 07-30-2011
Krishkamz; u summarized it well.
0 - ArchivalUser - 07-30-2011
calcium supplementation prevents absorption of thyroxine