Endo 14 - meduploader

[ArchivalUser]

A 75-year-old woman recently had a fractured hip. She has a history of hypertension and hypothyroidism, and has not been taking any medication for the last year. She lives alone and seldom leaves her house. She has a scanty diet and does not consume dairy products. She does not smoke cigarettes or drink alcohol. Her blood pressure is 170/95 mm Hg. She has a small, firm goiter and diffuse muscle weakness.

Laboratory Studies
Serum calcium

8.6 mg/dL
Serum phosphorus

2.4 mg/dL
Serum creatinine

0.8 mg/dL
Serum alkaline phosphatase

188 U/L
Serum thyroid-stimulating hormone

21 μU/mL

Which of the following tests would be most helpful in determining the cause of this patient’s skeletal disease?
( A ) Bone biopsy
( B ) Serum 25(OH) vitamin D
( C ) Serum 1,25(OH) 2 vitamin D
( D ) Serum free thyroxine
( E ) Serum protein electrophoresis

[ArchivalUser]

( B ) Serum 25(OH) vitamin D

[ArchivalUser]

b............both serum calcium and phosphate are low.......

[ArchivalUser]

B ) Serum 25(OH) vitamin D

[ArchivalUser]

B........

meduploader.....thanks
could any one write a little explanation for this qs please ??

[ArchivalUser]

pt stays at home, less exposure to sunlight and in labs low calcium and phosphorus and high PTH more likely to Vit D def.the next step is to look for low 25(OH) levels

[ArchivalUser]

krishkamz........thanks
if i remember well,thyroxine help absorption in the gut
is hypothyroidism making a mess here too ??

[ArchivalUser]

Krishkamz; u summarized it well.

[ArchivalUser]

calcium supplementation prevents absorption of thyroxine