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a patient presents with recurrent renal colic.. past history-- PUD takes daily famotidine..
LAB tests-- Na 140 K 4.0 Cl 103 creat 0.8 Ca 12 P 2.4
24 hr urinary Ca excretion 350mg (normal is 100 to 300)
what is the diagnosis???
A.. primary hyperPTH
B.. pagets ds
C..osteoporosis
D.. vit D def
E.. osteopetrosis
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A
i think she is having MEN 1, PUD...... due to inc gastrin, nd renal stones due to high PTH
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sorry not stones but hypercalciuria due to inc pth
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but can u tell me y she is having inc uinary Ca exc??? shouldnt that be low in primary PTH?
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sorry once again.. renal colic........ of course renal stones
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..increase PTH means primary hyperpathyroidsm..but y this reanal loss??
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ya exactly.. this is what i needed explanation about..
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Resorptive hypercalciuria is due to the loss of calcium from the body's normal stores in the bony skeleton and typically is found in hyperparathyroidism. In this condition, calcium is released from bone in response to the increased activity of osteoclasts caused by excessive and inappropriate serum PTH levels. This causes significant hypercalcemia. Under normal conditions, PTH causes the kidney to limit calcium excretion, but, with the overwhelming serum calcium load produced with hyperparathyroidism, the kidneys are forced to excrete the extra calcium into the urine, causing the hypercalciuria.Hope this helps
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hey thanks lasthope.. nice explanation..
