A 56-year-old woman presents with constipation, depressed mood, and a history of recurrent kidney stones. Vital signs: BP 138/88 mmHg, HR 58 bpm, RR 14, Temp 36.8°C, SpO2 98%. Laboratory studies show serum calcium 11.2 mg/dL (elevated), phosphate 2.1 mg/dL (low), and PTH 156 pg/mL (elevated). Serum TSH is normal. Abdominal imaging reveals calcium oxalate nephrolithiasis. Which of the following is the most likely underlying cause of her biochemical abnormalities?
- A)Vitamin D deficiency
- B)Chronic kidney disease
- C)Pseudohypoparathyroidism
- D)Autoimmune destruction of parathyroid glands
- E)Parathyroid adenomaGABARITO
Explicação
Primary hyperparathyroidism is most often caused by a parathyroid adenoma. Excess parathyroid hormone raises serum calcium through bone resorption, renal calcium reabsorption, and increased phosphate excretion, predisposing to stones, bones, groans, and psychi... Ver explicação completa e trilha adaptativa →