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  #1  
Old 06-01-2011
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Arrow A kid with a positive Chvostek response!

A 1-year-old boy presents with generalized seizures. His general physical examination findings are normal except for a prominently positive Chvostek response. Results of laboratory studies include total serum calcium of 4.5 mg/dL (1.1 mmol/L) and phosphorus of 8.2 mg/dL (2.73 mmol/L). Blood urea nitrogen and creatinine values are normal for age.

Of the following, the MOST likely diagnosis is:

a) dietary calcium deficiency
b) hypoparathyroidism
c) hyperphosphatasia
d) vitamin D deficiency rickets
e) vitamin D-resistant rickets
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hypoparathyroidism
As physical examination is normal ,so Rickets is unlikely..
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  #3  
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btw, this is positive Chvostek response:

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  #4  
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yeah chovstek sign is due to hypocalcemia..
it is +ve in hypovitaminosis D and hypoparathyroidism mainly..
Other causes are respiratory alkalosis and others i dont remember
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hahah..yeah i meant to say P/e is normal except this chovstek sign..
I mean if there is hypovitaminosis D wouldn't there be bowing of legs?
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Quote:
Originally Posted by struggle View Post
hypoparathyroidism
As physical examination is normal ,so Rickets is unlikely..
me too.
B) hypoparathyroidism
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hypoparathyroid
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Correct answer:

a) dietary calcium deficiency
b) hypoparathyroidism
c) hyperphosphatasia
d) vitamin D deficiency rickets
e) vitamin D-resistant rickets[/QUOTE]
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Old 06-01-2011
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Hello there,

This is his ECG would look like! I'm sure you all will spot on!

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Old 06-01-2011
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Default More facts for you guys!

Transient hypoparathyroidism is common during the first few days of life in preterm infants, infants of mothers with diabetes mellitus, infants of mothers with hypercalcemia, and infants with a prolonged delay in parathyroid gland responsiveness.

In general, patients with DiGeorge syndrome present during the first few weeks of life. In patients with velocardiofacial syndrome (DiGeorge variant) and autoimmune and PTH resistance syndromes (pseudohypoparathyroidism), hypocalcemia tends to present as late as adolescence.
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Old 06-01-2011
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Quote:
Originally Posted by 1TA2B View Post
Hello there,

This is his ECG would look like! I'm sure you all will spot on!

can u plez explain the ECG finding?
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Quote:
Originally Posted by pass7 View Post
can u plez explain the ECG finding?
- prolonged QT interval
- sinus bradycardia? not really...HR is >60
- ST changes (V1-V2)
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  #13  
Old 06-02-2011
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Quote:
Originally Posted by bebix View Post
A 1-year-old boy presents with generalized seizures. His general physical examination findings are normal except for a prominently positive Chvostek response. Results of laboratory studies include total serum calcium of 4.5 mg/dL (1.1 mmol/L) and phosphorus of 8.2 mg/dL (2.73 mmol/L). Blood urea nitrogen and creatinine values are normal for age.

Of the following, the MOST likely diagnosis is:

a) dietary calcium deficiency
b) hypoparathyroidism
c) hyperphosphatasia
d) vitamin D deficiency rickets
e) vitamin D-resistant rickets
hey..bt this pt has higher calcium and po4 leval..and in hypotyroidism there is decrease calcium leval....so how is it hypothroidism??pls correct me.....
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Originally Posted by drmdshah View Post
hey..bt this pt has higher calcium and po4 leval..and in hypotyroidism there is decrease calcium leval....so how is it hypothroidism??pls correct me.....
serum calcium of 4.5 mg/dL = hypo
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Quote:
Originally Posted by bebix View Post
serum calcium of 4.5 mg/dL = hypo
ohhh,..i got it...thnks...
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  #16  
Old 06-02-2011
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Quote:
Originally Posted by bebix View Post
- prolonged QT interval
- sinus bradycardia? not really...HR is >60
- ST changes (V1-V2)
Yes indeed
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