A 52-year-old woman with no past medical history presents with progressive fatigue and proximal muscle weakness. Vital signs: BP 138/88 mmHg, HR 92 bpm, RR 16/min, temp 37.2°C. Serum calcium is 11.8 mg/dL with normal albumin. PTH is suppressed at 8 pg/mL. Chest X-ray shows no pulmonary infiltrates. She denies recent medication use or vitamin supplement intake. Which of the following is the most likely cause of her hypercalcemia?
- A)Familial hypocalciuric hypercalcemia
- B)Vitamin D intoxication
- C)Malignancy-related hypercalcemiaGABARITO
- D)Primary hyperparathyroidism
- E)Hyperthyroidism
Explicação
This patient has hypercalcemia with suppressed PTH, indicating PTH-independent hypercalcemia. The most common cause is malignancy (via PTHrP secretion or osteolytic lesions). Malignancy should be investigated immediately in this clinical context. Ver explicação completa e trilha adaptativa →