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Author6 Posts
dr_jojo

03/10/07 - 04:22 AM       #1

A 67-year-old woman comes for a routine health maintenance examination. She drinks 1 ounce of alcohol daily. Her blood pressure is 138/62 mm Hg, pulse is 76/min and regular, and respirations are 14/min. The lungs are clear to auscultation. The remainder of the examination shows no abnormalities. Laboratory studies show:

Hemoglobin
12.8 g/dL
Serum

Ca2+
11.9 mg/dL
Creatinine
0.8 mg/dL
Phosphorus
2.8 mg/dL
Total protein
6.5 g/dL
Albumin
4.2 g/dL
Ionized calcium
5.8 mg/dL (N=4.5–5.1)

Which of the following is the most appropriate next step in management?

A
) Measurement of serum alkaline phosphatase activity

B
) Measurement of serum parathyroid hormone level

C
) Measurement of serum vitamin D level

D
) Serum and urine protein electrophoresis

E
) X-ray film of the chest

F
) Skeletal survey

G
) Bone scan




PTH 1ST






NE
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03/10/07 - 04:32 AM       #2

yes, PTH.

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Topics: 14
Posts: 126
03/10/07 - 05:28 AM       #3

B) Measurement of serum parathyroid hormone level


very good NE.



Adam
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Topics: 6
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03/10/07 - 07:52 AM       #4

increased Ca + decreased Phosphorus ==> do the PTH first, it could be hyperparathyroidism

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dr in trouble
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Topics: 62
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03/10/07 - 03:35 PM       #5

yes measure PTH levels




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eaguin
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Topics: 9
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03/11/07 - 04:50 PM       #6

PTH












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