Hypercalcemia And Hypocalcemia! Quiz

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| By Vwgirl4212
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Hypercalcemia And Hypocalcemia! Quiz - Quiz

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Questions and Answers
  • 1. 

    A 40 year old man is seen as a new patient to establish care.  He has no complaints.  His past medical history is negative.  Baseline laboratory studies are significant for serum calcium of 11.5 mg/dL.  Physical examination is normal.  What is the most common cause of asymptomatic hypercalcemia?

  • 2. 

    A 40-year-old man is seen as a new patient to establish care.  He has no complaints.  His past medical history is negative.  Baseline laboratory studies are significant for serum calcium of 11.5 mg/dL.  Physical examination is normal. In the above scenario, would this patient's parathyroid hormone level be:

    • A.

      High

    • B.

      Normal

    • C.

      Low

    Correct Answer
    A. High
    Explanation
    Based on the scenario provided, the patient's serum calcium level is high at 11.5 mg/dL. In a normal physiological response, the parathyroid hormone (PTH) level would be expected to be low to help bring down the elevated calcium level. However, since the answer is stated as "high," it suggests that the patient's PTH level is elevated. This could indicate primary hyperparathyroidism, a condition where the parathyroid glands produce excessive PTH, leading to increased calcium levels in the blood.

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  • 3. 

    A 40-year-old man is seen as a new patient to establish care.  He has no complaints.  His past medical history is negative.  Baseline laboratory studies are significant for serum calcium of 11.5 mg/dL.  Physical examination is normal. This patient's phosphate level would be:

    • A.

      High

    • B.

      Normal

    • C.

      Low

    Correct Answer
    C. Low
    Explanation
    The patient's serum calcium level is elevated, which suggests hypercalcemia. In cases of hypercalcemia, there is often a reciprocal decrease in serum phosphate levels. Therefore, the patient's phosphate level would be low.

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  • 4. 

    A 60-year-old man presents with complaints of fatigue and weakness for over 1 month.  His past medical history is negative.  His physical exam is significant for memory and cognitive defects.  His labs are calcium 15.0 mg/dL and phosphate of 2.3 mg/dL. Predict the parathyroid hormone values if this patient's hyercalcemia were due to Primary hyperparathyroidism.

  • 5. 

    A 60-year-old man presents with complaints of fatigue and weakness for over 1 month.  His past medical history is negative.  His physical exam is significant for memory and cognitive defects.  His labs are calcium 15.0 mg/dL and phosphate of 2.3 mg/dL. Predict the parathyroid hormone values if this patient's hypercalcemia were due to malignancy.

  • 6. 

    A 60-year-old man presents with complaints of fatigue and weakness for over 1 month.  His past medical history is negative.  His physical exam is significant for memory and cognitive defects.  His labs are calcium 15.0 mg/dL and phosphate of 2.3 mg/dL. Predict the parathyroid hormone values if this patient's hypercalcemia were due to vitamin D intoxication.

  • 7. 

    A 60-year-old man presents with complaints of fatigue and weakness for over 1 month.  His past medical history is negative.  His physical exam is significant for memory and cognitive defects.  His labs are calcium 15.0 mg/dL and phosphate of 2.3 mg/dL. Predict the parathyroid hormone values if this patient's hypercalcemia were due to granulomatous disorders.

  • 8. 

    A 60-year-old man presents with complaints of fatigue and weakness for over 1 month.  His past medical history is negative.  His physical exam is significant for memory and cognitive defects.  His labs are calcium 15.0 mg/dL and phosphate of 2.3 mg/dL. Predict the parathyroid hormone values if this patient's hyercalcemia were due to hyperthyroidism.

  • 9. 

    The most important action of vitamin D is to stimulate:

    • A.

      Calcium deposition in bone

    • B.

      Calcium resorption from bone

    • C.

      Calcium absorption from the GI tract

    • D.

      Calcium resorption in the renal tubule

    Correct Answer
    C. Calcium absorption from the GI tract
    Explanation
    The answer is C. Vitamin D probably acts in a permissive manner for all of these processes, but stimulation of calcium absorption from the GI tract is the most important direct action.

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  • 10. 

    Parathyroid hormone stimulates phosphate secretion in the proximal tubule.  True or false.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    The answer is false. PTH inhibits phosphate reabsorption, resulting in increased excretion. The increased excretion is the same result that would occur if secretion were increased, but phosphate is not secreted.

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  • 11. 

    In response to a sudden decrease in plasma calcium, where do most of the calcium come from to restore plasma levels?

    • A.

      The renal tubues

    • B.

      Bone

    • C.

      The GI tract

    Correct Answer
    B. Bone
    Explanation
    In response to a sudden decrease in plasma calcium, most of the calcium comes from the bone to restore plasma levels. This is because bone serves as a reservoir for calcium, and it can release calcium into the bloodstream when necessary. The process of releasing calcium from the bone is regulated by hormones such as parathyroid hormone (PTH) and calcitonin. These hormones help maintain calcium homeostasis by stimulating bone resorption (breaking down of bone) or bone deposition (formation of new bone) respectively. Therefore, the bone is the primary source of calcium during a sudden decrease in plasma levels.

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  • 12. 

    When a reduction in parathyroid hormone stimulates the kidneys to increase excretion of calcium, they do so by what mechanism?

    • A.

      Increased glomerular filtration

    • B.

      Reduced absorption in the proximal tubule

    • C.

      Increased secretion in the distal tubules

    • D.

      Increased reabsorption in distal tubule

    Correct Answer
    D. Increased reabsorption in distal tubule
    Explanation
    The answer is D. PTH stimulates calcium reabsorption in the distal tubule; thus, a reduction in PTH reduces reabsorption and permits more excretion.

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  • 13. 

    Chronic failure of the kidneys leads to what problem?

    • A.

      High plasma parathyroid hormone

    • B.

      Low plasma phosphate

    • C.

      Inability to transfer calcium from bone to the blood

    • D.

      High plasma vitamin D

    Correct Answer
    A. High plasma parathyroid hormone
    Explanation
    The answer is A. Chronic renal failure reduces phosphate excretion. As a consequence, levels of PTH increase, causing excessive resorption of calcium from bone.

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