04-15-2006, 08:37 AM
ML mechanism of hypocalcemia in a pt (60s, BMI 18, weight of 155 lb, disheveled, malnourished) with 20 yr hx of alcoholism, alcoholic hepatitis, jaundice, temporal wasting, scattered rhonchi heard throughout all lung fields, no abnormalities of cardiac exam, normal bowel sounds, liver span of 16, decrease sensation to pin prick and light touch over the feet, dec. deep tendon reflexes at the ankles? Lab shows: pos. occult blood stool, hemotocrit 33%; serum: Na 133. K 3.1, Cl 92, Mg 0.8, Ca 5.8, HCO3 26, BUN 6, Cr. 0.8; platelet count 145,000?
1. Renal resistance to PTH
2. Primary hyperparathyroidism
3. Impaired hydroxylation of vit D
4. Chronic metabolic acidosis
5. Hypomagnesemia
1. Renal resistance to PTH
2. Primary hyperparathyroidism
3. Impaired hydroxylation of vit D
4. Chronic metabolic acidosis
5. Hypomagnesemia