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A 40-Year-Old Woman Is Evaluated for Mildly Elevated Blood Pressure

Question 404

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A 40-year-old woman is evaluated for mildly elevated blood pressure. She complains of occasional low back pain, but she is otherwise in good health. Her other medical problems include type 2 diabetes mellitus, hyperlipidemia, and gastroesophageal reflux disease. She lives a sedentary lifestyle and spends the majority of her time indoors. Her mother suffered from a hip fracture at the age of 55. She has no family history of cancer.
Her blood pressure is 144/90 mm Hg and pulse is 78/min. Her BMI is 32 kg/m². Physical examination is unremarkable.
Laboratory results are as follows:
$A 40-year-old woman is evaluated for mildly elevated blood pressure. She complains of occasional low back pain, but she is otherwise in good health. Her other medical problems include type 2 diabetes mellitus, hyperlipidemia, and gastroesophageal reflux disease. She lives a sedentary lifestyle and spends the majority of her time indoors. Her mother suffered from a hip fracture at the age of 55. She has no family history of cancer. Her blood pressure is 144/90 mm Hg and pulse is 78/min. Her BMI is 32 kg/m<sup>2</sup>. Physical examination is unremarkable. Laboratory results are as follows: Dual energy x-ray absorptiometry (DEXA) T scores: She is treated with 50,000 IU of vitamin D2 (ergocalciferol) weekly for 4 weeks. Repeat laboratory data shows a serum calcium of 11.4 mg/dL and parathyroid hormone (PTH) levels of 75 pg/mL (normal 10-65 pg/mL) . Which of the following is the most likely diagnosis? A) Granulomatous disease B) Occult malignancy C) Primary hyperparathyroidism D) Secondary hyperparathyroidism E) Vitamin D intoxication$
Dual energy x-ray absorptiometry (DEXA) T scores:
$A 40-year-old woman is evaluated for mildly elevated blood pressure. She complains of occasional low back pain, but she is otherwise in good health. Her other medical problems include type 2 diabetes mellitus, hyperlipidemia, and gastroesophageal reflux disease. She lives a sedentary lifestyle and spends the majority of her time indoors. Her mother suffered from a hip fracture at the age of 55. She has no family history of cancer. Her blood pressure is 144/90 mm Hg and pulse is 78/min. Her BMI is 32 kg/m<sup>2</sup>. Physical examination is unremarkable. Laboratory results are as follows: Dual energy x-ray absorptiometry (DEXA) T scores: She is treated with 50,000 IU of vitamin D2 (ergocalciferol) weekly for 4 weeks. Repeat laboratory data shows a serum calcium of 11.4 mg/dL and parathyroid hormone (PTH) levels of 75 pg/mL (normal 10-65 pg/mL) . Which of the following is the most likely diagnosis? A) Granulomatous disease B) Occult malignancy C) Primary hyperparathyroidism D) Secondary hyperparathyroidism E) Vitamin D intoxication$
She is treated with 50,000 IU of vitamin D2 (ergocalciferol) weekly for 4 weeks. Repeat laboratory data shows a serum calcium of 11.4 mg/dL and parathyroid hormone (PTH) levels of 75 pg/mL (normal 10-65 pg/mL) .
Which of the following is the most likely diagnosis?

A) Granulomatous disease
B) Occult malignancy
C) Primary hyperparathyroidism
D) Secondary hyperparathyroidism
E) Vitamin D intoxication

A 40-Year-Old Woman Is Evaluated for Mildly Elevated Blood Pressure

Multiple Choice

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