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* Nbme 3 block 3 q44..
 #705496  
  andy_ks - 10/24/12 19:49
 
  44. A 62-year-old man with a 20-year history of alcoholism is admitted to the hospital for treatment of alcoholic hepatitis. He appears disheveled and malnourished. He is 198 cm (6 ft 6 in) tall and weighs 70 kg (155 lb). BMI is 18 kglm2. Examination shows jaundice and temporal wasting. Scattered rhonchi are heard throughout all lung fields. Cardiac examination shows no abnormalities. Bowel sounds are normal. The liver span is 16 cm. Sensation to pinprick and light touch is decreased over the feet. Deep tendon reflexes are decreased at the ankles. Laboratory studies show Platelet count 145,0001mm3
Serum
Na+ 131 mEq/L
Cl- 92 mEg1L
K+ 3.1 mEq/L
HC03 26 mEgIL
Mg2+ 0.8 mEgIL
Ca 2+ 5.8 mg1dL
Urea nitrogen (BUN) 6 mgfdL
Creatinine 0.8 mgldL

Test of the stool for occult blood is positive. Which of the following is the most likely mechanism of this patient's hypocalcemia?
O A) Chronic metabolic acidosis
O B) Hypomagnesemia
O C) Impaired hydroxylation of vitamin D
O D) Primary hyperparathyroidism
O E) Renal resistance to parathyroid hormone

Bbbbbbbbbbbbbbbbbbbbbb. How ans is b?....
 
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* Re:Nbme 3 block 3 q44..
#2763831
  saz - 10/25/12 00:34
 
  Mg is necessary for PTH to be released from the gland. Low Mg levels also lead to increased urinary loss of calcium.  
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* Re:Nbme 3 block 3 q44..
#2764523
  andy_ks - 10/25/12 19:30
 
  Thanks saz for clarifying my doubt...  
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* Re:Nbme 3 block 3 q44..
#2767558
  nader_s - 10/31/12 10:44
 
  alcohol-induced tubular dysfunction+/-diarrhea+/-acute pancreatitis >>
hypoMg(> producing PTH resistance or by decreasing PTH secretion(insevere HypoMg) >>HypoCa
 
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