01-13-2009, 11:28 AM
A 30-year-old woman is found to have asymptomatic hypercalcemia on a routine physical examination. She notes having an occasional milky discharge from her breasts. Her menses have been irregular for the past year. Both her mother and her sister have been previously diagnosed with pituitary tumors, and hypercalcemia. Her estimated oral calcium intake is 600 mg/d. On physical examination, she has expressible galactorrhea. Funduscopic examination and visual field testing are normal to confrontation.
Laboratory Studies
Calcium: 11.2 mg/dL (2.79 mmol/L)
Phosphorus: 2.5 mg/dL (0.81 mmol/L)
Chloride: 109 meq/L (109 mmol/L)
Albumin: 4.8 g/dL (48 g/L)
Intact parathyroid hormone: 55 pg/mL (55 ng/L): (normal 10-65 pg/mL)
Prolactin: 142 ng/mL (142 mg/L)
Which of the following therapies is most likely to correct the patient's hypercalcemia?
A An oral bisphosphonate
B Surgery to remove a parathyroid adenoma
C Surgery to remove a pheochromocytoma
D Surgery to remove 3½ parathyroid glands
E Surgery to remove a pituitary tumor
Laboratory Studies
Calcium: 11.2 mg/dL (2.79 mmol/L)
Phosphorus: 2.5 mg/dL (0.81 mmol/L)
Chloride: 109 meq/L (109 mmol/L)
Albumin: 4.8 g/dL (48 g/L)
Intact parathyroid hormone: 55 pg/mL (55 ng/L): (normal 10-65 pg/mL)
Prolactin: 142 ng/mL (142 mg/L)
Which of the following therapies is most likely to correct the patient's hypercalcemia?
A An oral bisphosphonate
B Surgery to remove a parathyroid adenoma
C Surgery to remove a pheochromocytoma
D Surgery to remove 3½ parathyroid glands
E Surgery to remove a pituitary tumor