によって Pablo Perez 4年前.
345
CC: Chronic Constipation x 5 years
The patient, a 48-year-old female, presents with chronic constipation persisting for five years and a history of hypertension managed with Metoprolol. Her medical history includes tobacco use and a need for depression screening.
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Increased Calcium and PO4 Serum PO4 Decreased Alk Phosphate Normal to high Serum PTH Elevated Secondary hyperparathyroidism Primary hyperparathyroidism Low to normal, consider... Granulomatous disease: sarcoidosis, TB Multiple Endocrine Neoplasia (MEN) Metastatic tumors (hypercalcemia of malignancy) CC: Chronic Constipation x 5 years Imaging Neck US Possible parathyroid adenoma DEXA scan Low bone density X-ray EKG Absent p waves Short QT interval Tall and peaked T waves Colonoscopy Management +/- Biphosphonates Laxatives prn Calcitonin Estrogen Demographics Female 48 y/o Labs Calcium: elevated Recheck 11.2 mg/dL (elevated)
Renal function TSH Normal FHx Both parents with HTN PMHx Screen for depression Tobacco use HTN Managed with Metoprolol
