A 65-year-old man with metastatic colon cancer presents with severe weakness, constipation, and polyuria. Vital signs: BP 92/58, HR 108, RR 18, Temp 37.2°C, SpO2 98% on room air. Serum calcium is 15.1 mg/dL; PTH is suppressed. Urinalysis shows no proteinuria. He denies recent thiazide use. Large-volume isotonic saline infusion is initiated. Which of the following best explains why this initial therapy helps lower his serum calcium level?

  1. A)It directly inhibits osteoclast activity
  2. B)It promotes intracellular shift of calcium
  3. C)It increases glomerular filtration and urinary calcium excretionGABARITO
  4. D)It binds serum calcium in the bloodstream
  5. E)It increases intestinal calcium absorption

Explicação

Aggressive isotonic saline repletion restores intravascular volume, increases GFR and enhances renal calcium excretion. Ver explicação completa e trilha adaptativa →

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