shirish_sss
Forum Senior
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A 30 YEARS OLD IMMIGRANT FROM MEXICO, CHRONIC SMOKER , PRESENTS WITH COMPLAINS OF FATIGUE, CONSTIPATION , MUSCLE WEAKNESS AND NAUSEA.
PATIENT HAD NO HISTORY OF DIABETES, HYPERTENSION OR PEPTIC ULCER DISEASE.
LABORATORY STUDIES REVEALED--------
SERUM CALCIUM-------- 13.5 mg/dl [NORMAL- 8.5 TO 10.5]
PLASME IMMUNOREACTIVE PARATHYROID HORMONE LEVEL--
-------- 158 pg/ml [NORMAL- 10 TO 15 pg/dl]
IMMUNOREACTIVE PARATHYROID HORMONE RELATED PEPTIDE LEVEL--
--------- NORMAL
WHICH OF THE FOLLOWING IS THE MOST LIKELY DIAGNOSIS ?
1) PSEUDOHYPOPARATHYROIDISM
2) EXCESS OF VITAMIN D
3) HYPERCALCEMIA OF MALIGNANCY
4) BENIGN TUMOUR OF PARATHYROID GLAND
5) SARCOIDOSIS
6) EXCESS DIETARY CALCIUM INTAKE
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| Delusional
Forum Elite
Topics: 41
Posts: 226
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40 Bengin tumor of the Parathyrpoid...
Parathyroid adenoma.....secretes PTH and is asscoiated with non malignant elevation of calcium sometimes difficult to diagnose hypercalcemia in these pateints...
It is the most common cause of outpatinet hypercalcemia
And another important lab finding is the low phosphate level....
The rest..malignancy ...first the PTH related peptide has to be elevated....and the hypercalcemia is usually an inpatient one....serious and this patient is just too young for maligancy even if he has been smoking for long....(i hope)
Sarcoidosis and other granulomatous diseases are realted to raised Vit D ...therefore the PTH isn't affected......
Pseudohypoparathyroidism is associated with Hypocalcemia but the parathyroid hormone is actually High and the tissues are resistant to it........
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| shirish_sss
Forum Senior
Topics: 32
Posts: 134
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THAT WAS A MARVELLOUS EXPLANATION DEL...... :lol: :lol: :lol: :lol:
YOU R TOTALLY CORRECT........
YOUR EXPLANATION IS SO PERFECT THAT I NEED NOT ADD ANYTHING TO IT........ :lol: :lol: :lol:
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