a Jasmine Juliette 3 éve
251
Class Assignment JAMJ Endo Sp 21
A 48-year-old woman presents with severe constipation and multiple other health concerns, including hypercalcemia, osteoporosis, and muscle weakness. Elevated parathyroid hormone levels and abnormal EKG findings, such as shortened QT intervals and bradyarrhythmias, indicate possible underlying issues.
Megnyitás
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
