MKSAP: 58-year old woman with fatigue and weight loss
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 58-year old woman is evaluated for a 3-week history of fatigue and weight loss. The patient has no significant medical history and takes no prescription medication, but she does take a daily over-the-counter multivitamin and a calcium supplement. She has a 50-pack-year smoking history.
Physical examination reveals a lethargic, ill-appearing woman. Temperature is 37.3 °C (99.1 °F), blood pressure is 136/78 mm Hg, pulse rate is 95/min, and respiration rate is 12/min. Other physical examination findings are unremarkable.
Laboratory studies:
Hemoglobin
8.3 g/dL (83 g/L)
Albumin
4.6 g/dL (46 g/L)
Blood urea nitrogen
43 mg/dL (15.4 mmol/L)
Calcium
14.5 mg/dL (3.6 mmol/L)
Creatinine
2.4 mg/dL (212 µmol/L)
Sodium
145 mEq/L (145 mmol/L)
A chest radiograph shows a 5-cm mass in the right lower lobe of the lung but is otherwise unremarkable.
Which of the following is the most likely cause of her hypercalcemia?
A: Malignancy
B: Primary hyperparathyroidism
C: Sarcoidosis
D: Vitamin D intoxication
Continue reading ...
Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.
Source: Kevin, M.D. - Medical Weblog - Category: Family Physicians Tags: Conditions Cancer Endocrinology Source Type: blogs
More News: Calcium | Cancer | Cancer & Oncology | Endocrinology | Family Physicians | Hyperparathyroidism | Laboratory Medicine | Partnerships | Radiography | Sarcoidosis | Smokers | Study | Vitamins | Weight Loss