A 70-year-old woman with limited sun exposure and poor nutritional intake presents with diffuse bone pain and proximal leg weakness. Vital signs: BP 138/82, HR 88, RR 16, Temp 37°C, SpO2 98% on room air. Laboratory studies reveal serum calcium 7.2 mg/dL, phosphate 2.1 mg/dL, alkaline phosphatase 95 U/L, and PTH 185 pg/mL. 25-hydroxyvitamin D is severely reduced. Cognitive function remains intact. Which diagnosis best explains these findings?
- A)Primary hyperparathyroidism
- B)Pseudohypoparathyroidism
- C)Thyrotoxicosis
- D)Paget disease of bone
- E)Vitamin D deficiency osteomalaciaGABARITO
Explicação
Vitamin D deficiency reduces intestinal absorption of calcium and phosphate, leading to secondary hyperparathyroidism and defective bone mineralization. Ver explicação completa e trilha adaptativa →