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  #1  
Old 07-27-2012
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Bones Bones are Hungry!

A 60-year-old woman complains of a 1-year history of bone pains, anorexia, weight loss, and constipation. Serum calcium is elevated and she is diagnosed with primary hyperparathyroidism. She is treated surgically, with removal of her parathyroid adenoma. She then has a long period of hypocalcemia and requires continuous treatment with vitamin D and calcium. Subsequently, after 6 months she becomes normocalcemic and does not need therapy. Which of the following conditions best explains these events?

A. Her remaining 3 parathyroid glands were destroyed
B. She has unrecognized pseudohypoparathyroidism
C. She had severe bone disease
D. She has pancreatitis from hyperparathyroidism
E. The wrong parathyroid gland was removed
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  #2  
Old 07-27-2012
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This is a weirdly-worded question, but I think the answer is B. When she had hyperparathyroidism, her peripheral receptors probably became less sensitive to PTH. So when her adenoma was removed, her remaining three parathyroid glands were probably functioning normally, but she was hypercalcemic because her receptors weren't responding well to the normal levels of PTH. This is called pseudohypoparathyroidism... PTH levels are normal/high, but calcium goes down because of poor peripheral sensitivity.

Over time, the receptors will regain their sensitivity and she'll become normocalcemic.
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Old 07-28-2012
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haha -- i rememebr this one ---- hungry bone syndrome!!

basically that after u remove the PTH glands -- the bones that were so far giving up Ca2+ now go into overdrive --- and absorb great amounts of calcium giving rise to a TRANSIENT low serum calcium levels.

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  #4  
Old 07-28-2012
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Huh, interesting. So the answer is C?
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Old 08-25-2013
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Quote:
Originally Posted by shan564 View Post
This is a weirdly-worded question, but I think the answer is B. When she had hyperparathyroidism, her peripheral receptors probably became less sensitive to PTH. So when her adenoma was removed, her remaining three parathyroid glands were probably functioning normally, but she was hypercalcemic because her receptors weren't responding well to the normal levels of PTH. This is called pseudohypoparathyroidism... PTH levels are normal/high, but calcium goes down because of poor peripheral sensitivity.

Over time, the receptors will regain their sensitivity and she'll become normocalcemic.
No, for psudohypoparathyroidism is accompanied by a short forth finger, round face, and mental retardation.
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  #6  
Old 08-26-2013
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so the answer is C , that means she had severe bone diseases
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