Pales, bone Ca cases Flashcards
1
Q
39 y.o F on birth control and MVI
Ca shows high Ca
otherwise normal CBC and CMP
next step
A
check PTH
2
Q
39 y.o F on birth control and MVI Ca shows high Ca otherwise normal CBC and CMP high PTH next step
A
24 hour urinary Ca
3
Q
39 y.o F on birth control and MVI Ca shows high Ca otherwise normal CBC and CMP high PTH urine Ca is high
A
primary hyperPTH
4
Q
53 y.o F with cc weakness, malaise, constipation and back pain becomes somewhat lethargic normal CXR, low albumin, high Ca normal phosphorus high chloride, high BUN high creatinine next step
A
Tx Ca
check PTH
5
Q
53 y.o F with cc weakness, malaise, constipation and back pain becomes somewhat lethargic normal CXR, low albumin, high Ca normal phosphorus high chloride, high BUN high creatinine how Tx the hyper Ca?
A
loop diuretics- furosemide
IV bisphosphonates– alendronate
6
Q
53 y.o F with cc weakness, malaise, constipation and back pain becomes somewhat lethargic normal CXR, low albumin, high Ca normal phosphorus high chloride, high BUN high creatinine low PTH next step?
A
check for malignancy Vit D lab PTHrP bone scan TSH and freeT4 T3 multiple myeloma (SPEP/UPEP) ACE level for sarcoidosis
7
Q
SPEP UPEP
A
serum and urine protein electrophoresis
8
Q
71 y.o F poor appetite weight loss, cramps and weakness PMH crohns \+ trousseaus sign Ca low low next step
A
albumin
9
Q
71 y.o F poor appetite weight loss, cramps and weakness
PMH crohns
+ trousseaus sign
Ca low low
low albumin so corrected Ca still a little low
next step
A
PTH
PO4
Cr
alkaline phosphatase
10
Q
71 y.o F poor appetite weight loss, cramps and weakness PMH crohns \+ trousseaus sign Ca low low low albumin so corrected Ca still a little low low PO4 normal Cr high alkaline phosphatase high PTH differential?
A
Vit D problem
11
Q
71 y.o F poor appetite weight loss, cramps and weakness PMH crohns \+ trousseaus sign Ca low low low albumin so corrected Ca still a little low low PO4 normal Cr high alkaline phosphatase high PTH low 25 hydroxy vit D Dx?
A
Vit D deficiency
12
Q
what you expect to see on XR and DEXA of a patient with Vit D deficiency
A
decreased bone density- osteoporosis
13
Q
35 y.o F with thyroid cancer
had total thyroidectomy
3 days after surgery had facial cramps
A
hypoCa
14
Q
best osteoporosis Tx for women with previous Hx breast cancer
A
estrogen modulator drugs
