Hypocalcemia, Hypophosphatemia, diarrhea, stool fat globules? - USMLE Forums
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Old 10-22-2015
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Question Hypocalcemia, Hypophosphatemia, diarrhea, stool fat globules?

I am having trouble figuring out the correct answer and explanation for this question from online NBME 6. Not sure what is going on. Please help.


A 32-year-old man comes to the physician because of intermittent diarrhea for 6 months. He has had a 5.4 kg (12-lb) weight loss during this period. Vital signs are within normal limits. Examination shows no abnormalities. Serums studies show a calcium concentration of 7.8 mg/dL and a phosphorus concentration of 2.2 mg/dL. Examination of a stool specimen shows fat globules. Which of the following is the most likley explanation for this patient's hypocalcemia?

A) Parathyroid hormone deficiency
B) Vitamin A excess
C) Vitamin B1 (thiamine) deficiency
D) Vitamin B12 (cobalamin) deficiency
E) Vitamin D deficiency
F) Vitamin E deficiency
G) Vitamin K deficiency


I randomly chose A. That is wrong. I am thinking..maybe Vitamin D deficiency? Not sure
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Old 10-22-2015
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Quote:
Originally Posted by nileprincess05 View Post
I am having trouble figuring out the correct answer and explanation for this question from online NBME 6. Not sure what is going on. Please help.


A 32-year-old man comes to the physician because of intermittent diarrhea for 6 months. He has had a 5.4 kg (12-lb) weight loss during this period. Vital signs are within normal limits. Examination shows no abnormalities. Serums studies show a calcium concentration of 7.8 mg/dL and a phosphorus concentration of 2.2 mg/dL. Examination of a stool specimen shows fat globules. Which of the following is the most likley explanation for this patient's hypocalcemia?

A) Parathyroid hormone deficiency
B) Vitamin A excess
C) Vitamin B1 (thiamine) deficiency
D) Vitamin B12 (cobalamin) deficiency
E) Vitamin D deficiency
F) Vitamin E deficiency
G) Vitamin K deficiency


I randomly chose A. That is wrong. I am thinking..maybe Vitamin D deficiency? Not sure

EEEE fat malabsorption Vit A D E K is fat soluble, only vit D def will cause hypocal
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Old 10-25-2015
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Default Hey

To take it a step further hypoparthyroidism causes decreased Calcium but increased phosphate. Vitamin D deficiency has decreased phosphate (which becomes great exaggerated due to the secondary increase in PTH) and decreased calcium. This is a very key distinction.
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