Question

a 39-year-old female presents with elevated elevated calcium, elevated sodium, and elevated phosphorus. what is your working diagnosis?
a) hypocalcemia
b) hyperparathyroidism
c) bone breakdown
d) hypoparathyroidism
e) metastsis

Explanation:

To determine the working diagnosis, we analyze each option:

• Option a: Hypocalcemia is low calcium levels, but the patient has elevated calcium, so this is incorrect.
• Option b: Hyperparathyroidism involves overactive parathyroid glands, which can lead to elevated calcium, sodium, and phosphorus due to increased parathyroid hormone (PTH) affecting mineral metabolism. This matches the lab findings.
• Option c: Bone breakdown (osteolysis) can cause elevated calcium, but it's more of a consequence or associated with other conditions (like cancer metastasis) rather than a primary diagnosis here, and it doesn't typically explain elevated sodium and phosphorus together as directly as hyperparathyroidism.
• Option d: Hypoparathyroidism causes low PTH, leading to low calcium (hypocalcemia) and high phosphorus, not elevated calcium/sodium, so incorrect.
• Option e: Metastasis (note spelling: "metastasis") from cancer can cause bone breakdown and elevated calcium, but it's less likely as a primary diagnosis for a 39 - year - old with these three elevated electrolytes without a known cancer history, and hyperparathyroidism is a more common primary endocrine cause for elevated calcium, sodium, and phosphorus in this context.

Answer:

b) hyperparathyroidism