NBME 24 Hematocrit: decreased;<br />Serum parathyroid hormone: increased;<br />Serum calcitriol: decreased (NBME Answers)

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submitted by radshopeful(17),

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jotajota94 she is also volume overloaded. more fluid leads to a decrease in Hematocrit. +5

h0odtime I thought PTH increases 1-alpha-hydroxylase which increases levels of 1 ,25? +1

batmane it's supposed to in the setting of proper kidney fxn +2

h0odtime Whoops +1

avocadotoast The decrease in GFR leads to decreased delivery of 25 dihydro vit D to the PCT and the decrease in functional renal mass limits production of 1a-hydroxylase. The increase in PO4 also stimulates FGF-23 from bone, which inhibits PO4 reabsorption and 1a-hydroxylase. +1