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Medicine Kidney d4ee5f31

Renal osteodystrophy differs from nutritional osteomalacia by having______.

A
Increased phosphates
B
Increased calcium
C
Decreased calcium
D
None of the above
High-Yield Explanation
Ans. a (Increased phosphates) (Ref. H-17th/2694)In addition to measuring serum calcium, it is useful to determine albumin, phosphorus, and magnesium levels. As for the evaluation of hypercalcemia, determining the PTH level is central to the evaluation of hypocalcemia. A suppressed (or "inappropriately low") PTH level in the setting of hypocalcemia establishes absent or reduced PTH secretion (hypopar- athyroidism) as the cause of the hypocalcemia. Further history will often elicit the underlying cause (i.e., parathyroid agenesis vs. destruction). By contrast, an elevated PTH level (secondary hyperparathyroidism) should direct attention to the vitamin D axis as the cause of the hypocalcemia. Nutritional vitamin D deficiency is best assessed by obtaining serum 25-hydroxyvitamin D levels, which reflect vitamin D stores.PRINCIPAL SYSTEMIC MANIFESTATIONS OF CHRONIC RENAL FAILURE AND UREMIAFluid and ElectrolytesCalcium Phosphate and Bone# Dehydration# Hyperphosphatemia# Edema# Hypocalcemia# Hyperkalemia# Secondary hyperparathyroidism# Metabolic acidosis# Renal osteodystrophy

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