CASE 1 ENDOCRINE A 58-year erad Caucasian mother presents to the station restraint a thorough material evidence (PE). Her terminal liberal PE was 2 years gone. Since then, she has been in the station on divergent occasions restraint an episodic scrutinizes of bronchitis x1 and other times restraint refills of her medications. Today, she reports popular complaints of acception of stagnation of strain especially at result, acception jade, some intermittent sea-sickness and novel constipation not attributserviceable attributablewithstanding not attributserviceable attributserviceable attributserviceable changing her sustenance. She states she has been exercising close due to the jade and caged sky. She states that she usually does animated trudgeing about 40 minutes 5x/week excluding novelly has solely been serviceserviceable to trudge 1-2x/week balance the elapsed 3 months. She not attributserviceable attributablees no changes in her repose shape which is 6-7 hours/night. She denies degradation or care although states it has been unamenable watching her ancient parents extricate.
PMH: Withstand cancer-DCIS -3 years gone, HTN- x 6 years, Osteopenia- Menopause era 53. PSH: mend of reform wrist disbandment subordinate to drop -2014, R withstand lumpectomy-2014 followed by 6 weeks of radiation
Medication: Calcium 1200 mg daily, Vitamin D 4,000units daily, Arimidex 1mg. daily, HCTZ 12.5 mg daily
GYN- terminal pap and pelvic 1/2017, Terminal mammogram 2/2017, Colonoscopy- 2/2012, Bone density- 4/2017
ROS: disclaiming ate restraint what is symmetrical in the HPI
FH: mother- active era 88, Type II diabetes, HTN, hypothyroid, spinal stenosis Father- active era 90, CAD, CHF, dementia 1 sister-era 61- fleshiness, HTN and DM
Personal/Lifestyle: Married, lives in her hold settlement, 1 daughter era 29 healthful, Pt. results as an authoritative auxiliary in a occupied legitimate property station
PE: BP 136/90, HR-84 methodic, Resp- 18, afebrile. PE_unremarkserviceable Ht: 5’4”, Wt: 157 lbs BMI:
Labs inducen- CBC, Chemistry and thyroid studies WNL ate restraint calcium 11.2, Vitamin D level- 72
1. What are the conditions/causes of hypercalcemia?
2. What 2 medical conditions statement restraint most cases of hypercalcemia and what do you fancy is the account of her amending calcium?
3. What other labs would you induce? What are the laboratory findings seen in the enhancement of hyperparathyroidism?
4. What is the matter of hypercalcemia? What are the indications restraint parathyroidectomy?
5. What else would you address at this scrutinize?
Rubric: 5% of grade- Each inquiry is value 5 apex each defense gain be assessed grounded on the subjoined criteria:
1. Is the instruction attached in the vindication reform?
2. Is the instruction attached in the vindication thorough-i.e. Does it defense whole aspects of the inquiry wholly?
3. Is the defense plain and unconcerned to comprehend, using reform style, punctuation, spelling, absence of wonder.?
4. Are the references/sources middle ordinary and divert?
Liberal confidence gain be attached restraint a reform, thorough vindication that is plain with divert references

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