10-13-2006, 02:49 PM
A 10-year-old boy is brought to the physician because of
weakness and decreased appetite for 3 months. He weighs 30 kg (66 lb) and is
142 cm (56 in) tall; he has had a 2.3-kg (5-lb) weight loss since his
last examination 6 months ago. He appears thin. Deep tendon reflexes
are brisk. Chvostek's sign is positive. His serum calcium level is 6.5
mg/dL, and serum intact parathyroid hormone level is 190 pg/mL
(N=9“65). In addition to calcium supplementation, which of the following is
the most appropriate next step in management?
A
) Oral phosphate supplementation
B
) Oral vitamin D supplementation
C
) Intranasal calcitonin therapy
D
) Parenteral bisphosphate therapy
E
) Parenteral parathyroid hormone therapy
weakness and decreased appetite for 3 months. He weighs 30 kg (66 lb) and is
142 cm (56 in) tall; he has had a 2.3-kg (5-lb) weight loss since his
last examination 6 months ago. He appears thin. Deep tendon reflexes
are brisk. Chvostek's sign is positive. His serum calcium level is 6.5
mg/dL, and serum intact parathyroid hormone level is 190 pg/mL
(N=9“65). In addition to calcium supplementation, which of the following is
the most appropriate next step in management?
A
) Oral phosphate supplementation
B
) Oral vitamin D supplementation
C
) Intranasal calcitonin therapy
D
) Parenteral bisphosphate therapy
E
) Parenteral parathyroid hormone therapy