A 72-Year-Old Woman Undergoes Parathyroidectomy for Primary Hyperparathyroidism

question 153

Multiple Choice

A 72-year-old woman undergoes parathyroidectomy for primary hyperparathyroidism.  Prior to surgery she complained of bone pain and had a compression fracture of the T11 vertebra.
Laboratory results from the day before surgery are as follows:

The patient had normal serum calcium on the first postoperative day.  She was discharged with a prescription for calcium and vitamin D.  Two days after surgery, she comes to the emergency department complaining of perioral numbness and spasms of both hands.  On examination, she appears anxious.  Her vital signs are normal except for a respiratory rate of 24/min.  Chvostek's sign is positive.
Which of the following laboratory results would be expected from blood drawn at this time?

• A)High calcium, low phosphorus, and high PTH
• B)Low calcium, high phosphorus, and high PTH
• C)Low calcium, low phosphorus, and normal PTH
• D)Normal total calcium, low ionized calcium, normal phosphorus, and normal PTH

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Definitions:

Hemorrhoids

Swollen and inflamed veins in the rectum and anus that cause discomfort and bleeding.

Rectum

The rectum is the final section of the large intestine, terminating at the anus, where feces are stored until they leave the body.

Anal Canal

The last few centimeters of the rectum.

Contrast Medium

A substance used in medical imaging to improve the contrast of structures or fluids within the body to allow for clearer imaging results.