DrVirgo
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An otherwise healthy 60 year old man undergoes a health maintenance exam. Physical exam and history are unremarkable. A blood chem panel is normal except for a serum calcium level of 11 mg/dL when corrected for serum albumin. The measurement is repeated two times, giving values of 10.5 mg/dL and 11.2 mg/dL, respectively. Serum phosphorus is 2.5 mg/dL, and Alk phos is 50mg/dL. There is also a higher than normal serum level of parathyroid hormone. Urine calcium excretion is wnl. The patient denies previous renal colic or urinary tract infections. Which of the following is the most appropriate step in management?
A. Bone x-ray films
B. Extensive cancer screening
C. Generous fluid intake
D. Treatment with bisphosphonates (alendronate)
E. Surgical exploration of the neck.
Explain why you choose your answer.
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| CocaCola
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d. treat with bisphosphonates
patient is asymptomatic with Ca levels below 12- no need for surgical intervention
(we should also increase hydration)
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| sprint123
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I think treatment with Alendronate --only when symptomatic..
At present, adequate hydration is sufficient??
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| surgeon99
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EEEEEEEEEEEEE hyper parathyrodism needs surgery
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| Aashi
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C.----->Generous fluid intake
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| prathapdoctor
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Generous fluid intake.
there is no need of treatment for asymptomatic hyperparathyroidism.
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| dr in trouble
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generous fluid intake.
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| prasannakumar
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C...excess fluid intake followed by diuresis. but if there is any fam H/o MEN I , go for surgery.
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| Justice
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C. Generous fluid intake
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| DrVirgo
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C is correct.
Bisphosphonates like alendronate only if symptomatic. 
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