A 47-Year-Old Man Comes to the Office Due to Recurrent

question 70

Multiple Choice

A 47-year-old man comes to the office due to recurrent kidney stones.  He passed his first stone 7 years ago and has subsequently passed 2 additional stones since then.  Analysis of one of the stones revealed a stone content of 85% calcium oxalate and 15% calcium phosphate.  His father and brother have both had kidney stones.  His medical history is significant for gastroesophageal reflux disease, mild intermittent asthma, and psoriasis.  He takes esomeprazole several times per week and uses an albuterol inhaler as needed for shortness of breath.  He is allergic to sulfa medications.  His blood pressure is 122/78 mm Hg and his pulse is 76/min.  BMI is 27kg/m².
The patient's blood work from 6 months ago is shown below.
The patient's current laboratory studies reveal:
Which of the following is the most appropriate recommendation for this patient?

• A)Dietary sodium restriction
• B)Esomeprazole discontinuation
• C)Dietary calcium restriction
• D)Vitamin D supplementation
• E)Increase animal protein in the diet

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Definitions:

Booking

The process of recording an individual's entry into the detention or jail system following an arrest.

Blotter

A blotter is an official record of events, transactions, or occurrences kept by an organization, often used in police departments to record crimes or incidents.

Excessive Bail

A bail amount deemed unreasonably high considering the circumstances and nature of the offence.

Eighth Amendment

A provision in the United States Constitution prohibiting the federal government from imposing excessive bail, excessive fines, or cruel and unusual punishments.