welcome redditors!to snoo-finity ... and beyond!

NBME 22 Answers

nbme22/Block 3/Question#42

A 62-year-old man comes to the physician for a ...

Inorganic phosphorus: increased;
Parathyroid hormone: increased;
Calcitriol: decreased

Login to comment/vote.

 +5  upvote downvote
submitted by bubbles(31),

Chronic renal insufficiency:

1) poor phosphate clearance --> high serum inorganic phosphorous

2) high serum phosphate --> complexes with divalent cation Ca --> Ca falls

3) Ca falls --> triggers PTH axis

4) kidney failure --> decreased activity of 1-hydroxylase at the kidney --> less calcitriol

 -4  upvote downvote
submitted by sne(13),

Since she has celiac spruce --> fat vitamin malabsorption, thus Vit. D is decreased Low vit. D = low calcitriol, low absorption of phosphate from intestine, and low absorption of Ca2+ causing an increase PTH