Class Assignment JAMJ Endo Sp 21

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CC: Chronic Constipation x 5 years

Szerző: Pablo Perez

My Future -Big Dream-Small Steps

Szerző: valeria lindemann

Sample Mind Map

Szerző: maritza trochez

New Big Horn Basin Site

Szerző: derek jurovich

Mrs. D, 48yo with severe constipation with Calcium level of 11.2

Treatment complications

Chronic Hypocalcemia needing lifelong supplementation of Ca2+ and Vitamin D

Recurrent Laryngeal nerve injury

Hypoparathyroidism

Additional Labs and Results

EKG - shortened QTi, Tall T waves, bradyarrythmias

DEXA - osteoporosis

XR - decreased bone density or normal

PTHrP - increased in malignancy

PTH - increased PTH

Urine: Hypercalciuria, Hyperphosphauria

Serum: Hypercalcemia, Hypophosphatemia, Low 20(OH) Vitamin D

Other Questions to ask the patient

Are you having headaches or feeling like you've had memory changes?

Are you feeling tired or depressed lately?

Any heart palpitations?

Any bone pain, muscle weakness or muscle pain?

Treatment

Surgical Exploration +/- Partial Parathyroidectomy

pt meets criteria for surgery

Endocrinology consult!

PE Findings

Shortened QT intervals

Fatigue

Abdominal pain, nausea and/or vomiting

Muscle weakness and atrophy

Decreased DTR's

Mild bone pain

DDx

Malabsorption Disease

MEN syndrome

Malignancy - Parathyroid adenoma, metastasis

Vitamin D intoxication

Primary Hyperparathyroidism