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 Best of Five 123

 

   

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BOF: 123

A 67-year-old female presents with anorexia, nausea vomiting and loss of weight. No other symptoms of note. On examination she was mildly dehydrated and looked unwell.

Investigations:

Hb 16.6 g/dl

WBC 4.7 x 109/l

ESR 13mm in the 1st hour

Sodium 136 mmol/l

Potassium 3.9 mmol/l

Chloride 111 mmol/l

Bicarbonate 27 mmol/l

Urea 10.2 mmol/l

Creatinine 126 micromoles/l

Albumin 44 g/l

Calcium 3.87mmol/l

Phosphate 0.62 mmol/l

Alkaline phosphatase 120 U/l

Which of the following is an unlikely cause for her hypercalcaemia

a)      Thyrotoxicosis

b)      Malignant disease

c)      Hyperparathyroidism

d)      Vitamin D therapy

e)      Renal failure

What is the best emergency treatment for this patient?

a)      Intravenous Bisphosphonates

b)      Steroids

c)      Calcitonin

d)      Intravenous phosphate

e)      Oral phosphates

 

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