A 45-year-old female patient presents with symptoms of tingling in the fingers, muscle cramps, and fatigue. Her laboratory results show low serum calcium, low parathyroid hormone (PTH) levels, and elevated serum phosphate levels. Based on these lab results, which of the following is the most likely diagnosis?
Primary hyperparathyroidism
Chronic kidney disease
Vitamin D deficiency
Hypoparathyroidism
The Correct Answer is D
Choice A Reason:
Primary hyperparathyroidism is characterized by elevated PTH levels, which lead to increased serum calcium levels and decreased serum phosphate levels. The patient’s lab results show low PTH and low serum calcium, which are not consistent with primary hyperparathyroidism.
Choice B Reason:
Chronic kidney disease (CKD) can cause disturbances in calcium and phosphate metabolism, but it typically presents with elevated PTH levels due to secondary hyperparathyroidism. The patient’s low PTH levels make CKD an unlikely diagnosis in this context.
Choice C Reason:
Vitamin D deficiency can lead to low serum calcium levels, but it usually results in elevated PTH levels as the body attempts to compensate for the low calcium. The patient’s low PTH levels do not align with a diagnosis of vitamin D deficiency.
Choice D Reason:
Hypoparathyroidism is characterized by low serum calcium, low PTH levels, and elevated serum phosphate levels. This condition occurs when the parathyroid glands do not produce enough PTH, leading to the observed lab results and symptoms such as tingling, muscle cramps, and fatigue. The patient’s lab results are consistent with hypoparathyroidism.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A Reason:
Cloudiness in the lens of the eyes is the hallmark symptom of cataracts. Cataracts cause the lens to become opaque, leading to blurred vision and difficulty seeing clearly. This cloudiness can make it challenging to perform everyday tasks and is the most indicative sign of cataracts.
Choice B Reason:
Double vision in one eye can occur with cataracts, but it is not the most indicative symptom. While cataracts can cause visual disturbances, the primary symptom is the cloudiness of the lens, which directly impacts vision clarity.
Choice C Reason:
Eye pain and redness are not typical symptoms of cataracts. These symptoms are more commonly associated with other eye conditions such as infections or glaucoma. Cataracts primarily cause visual disturbances without significant pain or redness.
Choice D Reason:
Sudden loss of vision is not characteristic of cataracts. Cataracts develop gradually over time, leading to a slow progression of vision impairment. Sudden vision loss is more likely to be associated with acute conditions such as retinal detachment or vascular occlusions.
Correct Answer is C
Explanation
Choice A Reason:
Acute lymphoblastic leukemia (ALL) is a type of cancer that affects the blood and bone marrow. While it can cause symptoms such as fatigue and fever, it is less likely to cause severe pain in the lower back and joints, which are more characteristic of a vaso-occlusive crisis in sickle cell anemia. ALL typically presents with symptoms like frequent infections, easy bruising or bleeding, and bone pain, but the combination of severe pain, fatigue, and fever in a patient with sickle cell anemia points more towards a vaso-occlusive crisis.
Choice B Reason:
Iron-deficiency anemia is a condition where there is a lack of adequate iron to form healthy red blood cells. Symptoms include fatigue, weakness, and pale skin, but it does not typically cause severe pain in the lower back and joints or fever. The presence of severe pain and fever in a patient with sickle cell anemia is more indicative of a vaso-occlusive crisis rather than iron-deficiency anemia.
Choice C Reason:
Vaso-occlusive crisis is a common and painful complication of sickle cell anemia. It occurs when sickled red blood cells block blood flow to parts of the body, causing severe pain, often in the back, joints, and abdomen. This condition can also lead to fever and fatigue due to the body’s inflammatory response and the reduced oxygen delivery to tissues. Given the patient’s history of sickle cell anemia and the described symptoms, a vaso-occlusive crisis is the most likely cause.
Choice D Reason:
Pneumonia is an infection that inflames the air sacs in one or both lungs, which can cause symptoms such as fever, chills, and difficulty breathing. While pneumonia can occur in patients with sickle cell anemia, it is less likely to cause severe pain in the lower back and joints. The combination of severe pain, fatigue, and fever in this patient is more consistent with a vaso-occlusive crisis.
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