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fatboyslim
The symptoms of this patient are due to hypercalcemia (stones, bones, groans, THRONES [increased diuresis}, and psychiatric overtones). Hypercalcemia can also cause peptic ulcer disease. So the primary pathology is parathyroid adenoma/hyperplasia causing the hypercalcemia
+6
beetbox
Does anyone know what's up with the 'no abnormalities in humerus Xray'?Did they just throw that in for no reason? I got hooked on it, I thought there was no increased osteoclast activity... otherwise the cortical bones would have been oddly thin or something
+4
topgunber
MEN 1 - P P P . Parathyroid, pancreas(gastrin in this case), pituitary lesion. not key to answering this question.
pt comes with symptoms of hypercalcemia, moans, groans, thrones (peeing), psych overtones.
Look at pth and calcium. we see high ca and high pth. We know that high calcium would lower pth...this means the high caclium was due to the high pth (i.e. parathyroid adenoma)
Question is actually asking: what are the effects of PTH? a, c, opposite of PTH
D and E i believed aren't related to PTH
B-Sounds something like the pathogenesis of pseudohyperparathyoidism
F- we definitely know that PTH increases Ca , so by increasing osteoclast maturation/activity you liberate calcium into the blood. this is the best answer.
+3
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yotsubato
I swear they make up some of this stuff. Like whats up with the thirst, urination, and peptic ulcer diseases.
+9
redvelvet
hypercalcemia can cause nephrogenic diabetes inspidus; so thirst, urination. hypercalcemia can also cause peptic ulcer disease. His symptoms are all about hypercalcemia due to hyperparathyroidism.
+4
dulxy071
Why can't the correct answer be C) which points towards renal failure, which may lead to secondary hyperparathyroidism having the same results I believe
+2
pmofmalasia
The secondary hyperparathyroidism in renal failure is due to loss of calcium in the non-functioning kidney. In this question the calcium was elevated, so you can rule out renal failure.
+1
sars
Hyper-calcemia causes stones (calcium stones), groans (constipation), thrones (increased urination), bones (increased osteoclast activation), and psychiatric overtones (depression).
+1
epiglotitties
@yotsubato also as someone mentioned in another comment, i think they're hinting that the px might have MEN1. Parathyroid hyperplasia- hypercalcemia, pituitary adenoma- SIADH (thirst+urination), and pancreatic tumor- gastrinoma (peptic ulcer disease)
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yotsubato
ugh, bullshit. I was trying to figure out an actual disease process here.
+7
rio19111
its primary hyperparathyroidism caused by parathyroid adenoma. addition of the peptic ulcer suggest Zollinger ---> MEN1
but none of that is imp because that's not what they are asking. All they are asking for is the function of PTH.
+3
topgunber
MEN 1 - P P P . Parathyroid, pancreas(gastrin in this case), pituitary lesion. not key to answering this question.
pt comes with symptoms of hypercalcemia, moans, groans, thrones (peeing), psych overtones.
Look at pth and calcium. we see high ca and high pth. We know that high calcium would lower pth...this means the high caclium was due to the high pth (i.e. parathyroid adenoma)
Question is actually asking: what are the effects of PTH? a, c, opposite of PTH
D and E i believed aren't related to PTH
B-Sounds something like the pathogenesis of pseudohyperparathyoidism
F- we definitely know that PTH increases Ca , so by increasing osteoclast maturation/activity you liberate calcium into the blood. this is the best answer.
+1
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topgunber
MEN 1 - P P P . Parathyroid, pancreas(gastrin in this case), pituitary lesion. not key to answering this question.
pt comes with symptoms of hypercalcemia, moans, groans, thrones (peeing), psych overtones.
Look at pth and calcium. we see high ca and high pth. We know that high calcium would lower pth...this means the high caclium was due to the high pth (i.e. parathyroid adenoma)
Question is actually asking: what are the effects of PTH? a, c, opposite of PTH
D and E i believed aren't related to PTH
B-Sounds something like the pathogenesis of pseudohyperparathyoidism
F- we definitely know that PTH increases Ca , so by increasing osteoclast maturation/activity you liberate calcium into the blood. this is the best answer.
+1
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rio19111
Stones, groans, thrones, psychiatric overtones ---> symptoms
+1
topgunber
MEN 1 - P P P . Parathyroid, pancreas(gastrin in this case), pituitary lesion. not key to answering this question.
pt comes with symptoms of hypercalcemia, moans, groans, thrones (peeing), psych overtones.
Look at pth and calcium. we see high ca and high pth. We know that high calcium would lower pth...this means the high caclium was due to the high pth (i.e. parathyroid adenoma)
Question is actually asking: what are the effects of PTH? a, c, opposite of PTH
D and E i believed aren't related to PTH
B-Sounds something like the pathogenesis of pseudohyperparathyoidism
F- we definitely know that PTH increases Ca , so by increasing osteoclast maturation/activity you liberate calcium into the blood. this is the best answer.
+1
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submitted by cafeaulait(11)
I believe this stem may be inferring MEN 1 syndrome - possible gastrinoma (peptic ulcer disease dx), parathyroid adenoma, and pituitary adenoma (causing SIADH). But, you don't need to even know this to get this right - just asking the effect of high PTH on the system - causes increased osteoclast activity as well as maturation.