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Chvostek's - guest78
#1
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

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#2
bbb
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#3
answer ????

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#4
correct. good going.
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#5
kindly post explanations also.
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#6
he has calcium deff.1st thing to change is 25 OH vit D
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#7
nursing home resident ...no proper sunexposer...vit d deficiency....
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#8
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.
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