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NBME 18 Answers

nbme18/Block 1/Question#10

25 yo woman, polycystic kidneys

HCO3: decreased; inorganic PO4: increased; parathryroid hormone: increased

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submitted by cbrodo(16),

Renal damage from PKD can ultimately cause chronic renal insufficiency. This impairs the ability of the kidney to excrete phosphorus and reabsorb HCO3. Elevated phosphate levels in the blood triggers release of FGF-23 from bone, which lowers vitamin D production and decreases calcium absorption in the intestine. The resulting hypocalcemia and hyperphosphatemia will lead to an increase in the secretion of PTH.