Endocrinology Question 46

A 67-year-old man is evaluated for a recent diagnosis of primary hyperparathyroidism after an elevated serum calcium level was incidentally detected on laboratory testing. Medical history is significant only for hypertension, and his only medication is ramipril.

On physical examination, temperature is 35.8 °C (96.4 °F), blood pressure is 120/68 mm Hg, pulse rate is 62/min, and respiration rate is 14/min. BMI is 32. The remainder of his examination is unremarkable.

A dual-energy x-ray absorptiometry (DEXA) scan shows T-scores of –1.3 in the right femoral neck, –1.0 in the lumbar spine, and –1.4 in the non-dominant forearm. Fracture Risk Assessment Tool (FRAX) score indicates a 13% risk of major osteoporotic fracture and a 1.9% risk of hip fracture over the next 10 years.

Which of the following is the most appropriate management of this patient?

A Refer for parathyroidectomy

B Start alendronate

C Start calcitonin

D Start cinacalcet

E Start vitamin D3 (cholecalciferol)

Choose an Answer Above

Have your answer...click Next Page to see if you're right.

Powered ByCareerCast