An 8-year-old child presented to the Emergency Room with constipation, anorexia, lethargy and behavioural abnormality. Bony erosion of the phalanges was seen on wrist radiography.... An 8-year-old child presented to the Emergency Room with constipation, anorexia, lethargy and behavioural abnormality. Bony erosion of the phalanges was seen on wrist radiography. Parathyroid hormone (Intact PTH levels) 6.2 pmol/L (Normal Value: 1.1-5.3 pmol/L). Parathyroid hormone (C-terminal fraction) 11 pmol/L (Normal Value: 0.8-2.5 pmol/L). Calcium total 5.3 mmol/L (Normal Value: 2.2-2.7 mmol/L). Phosphate 1.2 mol/L (Normal Value: 1.3-2.3 mol/L). Magnesium 0.9 mol/L (Normal Value: 0.7-1.0 mol/L). Which of the following is the best management approach? A. Rehydration and statins B. Diuretics and rehydration. C. Bisphosphonates, diuretics and statins D. Rehydration, diuretics and bisphosphonates.
Understand the Problem
The question presents a clinical scenario of an 8-year-old child with symptoms like constipation, anorexia, lethargy, and behavioral changes, along with bony erosion. Lab results show elevated parathyroid hormone and calcium levels with decreased phosphate. The question asks for the best management approach based on these findings. The elevated calcium levels hint at hypercalcemia, and we need to choose the option that best addresses hypercalcemia in a child.
Answer
The best management approach is Rehydration, diuretics and bisphosphonates.
The best management approach is D. Rehydration, diuretics and bisphosphonates.
Answer for screen readers
The best management approach is D. Rehydration, diuretics and bisphosphonates.
More Information
The 8-year-old child's symptoms and lab results indicate hypercalcemia. The best management approach would be D. Rehydration, diuretics and bisphosphonates.
Tips
It is important to note the normal values for each measurement, in order to identify abnormalities in the patient's results.
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