By Alluru S. Reddi
Written in a succinct query and resolution structure, this finished source covers all components of nephrology and customary scientific situations. approximately a thousand questions with particular solutions supply nephrology fellows, training nephrologists and clinicians a greater figuring out of nephrology and relief arrangements for nephrology and inner medication forums. Absolute Nephrology evaluation good points the most recent facts and directions whereas pleasing a severe want in the nephrology community.
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Additional info for Absolute Nephrology Review: An Essential Q & A Study Guide
9 mg/dL, which was confirmed by determining ionized Ca2+ on a routine physical examination. His Mg2+ is also slightly elevated and phosphate is low. His intact PTH level is 70 pg/mL, and vitamin D levels are normal. All other labs are normal. He is not on any medications. Physical examination is normal. He also had elevated serum Ca2+ 10 years ago when he was admitted to hospital for cough and sputum production. Which one of the following is the MOST likely diagnosis in this subject? A. B. C. D.
Reactivation of TB is possible, but the extent of Ca2+ and low 1,25(OH)2D3 levels make this diagnosis unlikely (B is incorrect). Also, vitamin D and FHH are unlikely because of the extent of Ca2+ (D and E are incorrect). This patient seems to have an underlying malignancy that is causing very high levels of Ca2+ (C is correct). Suggested Reading Reddi AS. Disorders of calcium: Hypercalcemia. In Reddi AS. Fluid, Electrolyte, and Acid-Base Disorders. Clinical Evaluation and Management. New York, Springer, 2014, pp.
Topiramate causes non-AG metabolic acidosis due to inhibition of carbonic anhydrase. Serum L-lactate is normal; therefore, L-lactic acidosis is excluded. Also, methanol intoxication is excluded based on normal osmolal gap. There is no history of medication (Tylenol or Tylenol-containing narcotics) or antibiotic use. Therefore, pyroglutamic acidosis is ruled out. Based on the surgical history, high carbohydrate intake, and neurologic manifestations, the most likely diagnosis is D-lactic acidosis.
Absolute Nephrology Review: An Essential Q & A Study Guide by Alluru S. Reddi