sunny2
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Ziang Chin tee pin lin a 64 years old male , who loves Scotch and Cognac ,is a diehard fan of Marlborro and Camel and loves to eat KFC and Mac double triple cheese hamburger since last 35 years comes to you with a bag of dorittos in one hand and a bottle of Johny walker on the other, jolly as he is allways tells you that he had a hip fracture last year and a wrist fracture 2 months back , his back hurts when he walks.Vitals are normal. Since you have studied for USMLE step 2 CK so hard you thought it can be a case of Osteoporosis, you also know that most common method of assesing bone density is dual energy x-ray absorptiometry, you did that but now just think what is the Most Common method of assesing Calcium loss in Zian Chin tee pin lin who loves Scotch and Cognac and is a diehard fan of Marlborro and Camel :
1. Decreased Blood Calcium level
2. Increased Phosphate
3. 24 hour Urine calcium
4. Brittle nails
5. Vitamin D level
6. Low Albumin
7. PTH
8. NTX
9. ECG-decreased QT
10.12-h urine hydroxyproline
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| tolito
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4?
not accurate though.
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| study_ing
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3
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| saadtazjam
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7?
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| cbenitesch
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24 hours urine calcium
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| sunny2
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24 hour Urine calcium is not the most common method of assesing Calcium loss in Osteoporosis 
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| sunny2
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please write if you have any good source (apart from online websites/googling ) to prove that indeed 24 hour Urine calcium is the most common method of assesing Calcium loss in Osteoporosis.
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| ssrpk
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high turnover osteoporosis, hydroxyproline is very sensitive to assess the extent of bone resorption as it is a metabolite of collagen breakdown!
i'll place my bets with 10) 12 h urine hydroxyproline.
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| saadtazjam
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can Hypocalcemic disorders be due to hypoparathyroidism ? if so why not measure PTH?
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| ssrpk
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yeah but the Hx gives no indication in tht regard! besides it does'nt even say or sugest tht the pt. is hving hypocalcemia [serum levels] so PTH is definitely out!
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| sunny2
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Yes, PTH is out 
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| Shaina
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is it 3..whts answer ,pls explain.
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| sunny2
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The Most Common method of assesing Calcium loss is NTX (N-telopeptide, a bone breakdown product ) or 24- hour Urine Hydroxyproline.
ssrpk....u were close but we have to be attentive on the complete answer choice as instead of 12 hour it was 24 h-ur.hydroxyproline
study_ing, 24 hr-urine calcium was the answer I would have also choosen, but this answer source is Kaplan.....so u kno doesn't matter how many times you go thru the material...allways there is something new hidden somewhere ....that's medicine
Enjoy 
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| study_ing
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thanx sunny2..its scary though that the most commonmethod is something ive never heard of!!
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| sunny2
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yes study_ing, this was indeed scary for me too, once I thought of postponing the exam after I got couple of easy questions wrong and then this one....and specially when this is written in Kaplan notes which I thought I have done pretty well ....but you know , you can never know everythin , let's hope for the best.
Good luck to you
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| ssrpk
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NTX....never heard of that!
thnax for the info!
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