تم الحل ✓
categoryطب عام وطب أسرة
schoolبكالوريوس
event_available2026-07-14
السؤال
Transcribed Image Text:
A 40-year-old woman presents to her physician com-
plaining of marked left flank pain that began the previous
night. She reports that the pain is worse than that of giving
birth. She also reports blood in her urine earlier on the day
she came to see her doctor. She has felt more fatigued and
as if her concentration has not been as good as normal for
the last year or so, and she feels more forgetful. She has no
significant past medical history. She is taking no medica-
tions. Family history contributes no pertinent information.
On physical examination, she appears to be in extreme pain.
There is marked tenderness on very gentle percussion over
the left costovertebral angle. Labs are drawn and are notable
for calcium 11.2 mg/dL (normal, 8.5 to 10.2 mg/dL), albu-
min 3.8 g/dL (normal, 3.5 to 4.8 g/dL), and intact PTH 162
pg/mL (normal, 11 to 54 pg/mL). Renal function is normal
(BUN 25 mg/dL and creatinine 0.9 mg/dL). Urine analysis
is notable for blood and greater than 50 red blood cells per
high-power field. This prompts a 24-hour urine collection,
which reveals calcium elevated at 483 mg per 24 hour (nor-
mal, 100 to 250 mg per 24 hour).
Questions
1. Which laboratory results are abnormal?
2. What is the presumptive diagnosis for this patient?
The differential diagnosis?
3. What treatment is indicated for this disease?
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