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NBME 23 Answers

nbme23/Block 4/Question#3

A 33-year-old woman comes to the physician for a ...

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

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submitted by lfsuarez(114),

Answer E

Inorganic Phosphorus ; Parathyroid Hormone ; Calcitriol

Decreased ; Increased ; Decreased

This patient is suffering from celiac sprue, which in this case has caused Vitamin D malabsorption and therefore decreased serum calcium. The body will respond to the decreased calcium via secretion of PTH. This will then cause phosphorous wasting to occur in the proximal convoluted tubule.

kuhnboom  Why does Calcitriol not increase with the increased PTH? Wouldn't the increased PTH stimulate the kidneys to make more activated vitamin D. +1  
batmane  vitamin d malabsorption --> dec calcitriol +