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Pathology Parathyroids 255b7237

A 40-year-old woman with a history of hyperparathyroidism presents with a 2-month history of burning epigastric pain. The pain can be relieved with antacids or food. The patient also repos a recent history of tarry stools. She denies taking aspirin or NSAIDs. Laboratory studies show a microcytic, hypochromic anemia . Gastroscopy reveals a bleeding mucosal defect in the antrum. Which of the following best characterizes the pathogenesis of epigastric pain in this patient?

A
Decreased Calcium resorption by renal tubules
B
Decreased serum levels of PTH
C
Gastric nonresponsiveness to PTH
D
Increased secretion of Gastrin
High-Yield Explanation
- Given clinical features point towards Peptic ulcer disease, secondary to hyper-parathyroidism. - Incidence of peptic ulcer disease is increased in patients with hyperparathyroidism, because hypercalcemia increases serum gastrin, thereby stimulating gastric acid secretion. - None of the other choices are associated with gastric ulcers. - Peptic ulcers in context of MEN-1 may be secondary to Zollinger Ellison syndrome

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