If you find the material on this website useful, you will find that the two books ACES for PACES and KEYS to SUCCESS in Medicine complement the material on these sites and will enhance your studying and revision

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BOF: 1

A 30-year-old female presents with fatigue, weight loss, red, painful tender nodules over her shins and breathlessness. The chest X-ray shows bilateral hilar lymphadenopathy. Investigations show that she has hypercalcaemia.

The cause of the hypercalcaemia is:

a)      Increased parathyroid hormone production in the lungs

b)      A high serum ACE causing increased hydroxylation of 25 hydroxycholecalciferol to 1,25 dihydroxycholecalciferol in the kidney

c)      Alpha hydroxylation of 25 hydroxycholecalciferol to 1, 25 dihydroxycholecalciferol by macrophages in the lung

d)      Lytic lesions in the bones

e)      Hyperventilation

Answer:

c)

The patient has sarcoidosis. In this condition alpha hydroxylation of 25 hydroxycholecalciferol to 1,25 dihydroxycholecalciferol takes place in sarcoid macrophages in the lungs. This increases levels of calcitriol in the blood and results in hypercalcaemia.

Revision Tip

Revise erythema nodosum ACES for PACES page 155

Revise sarcoidosis KEYS to SUCCESS in Medicine pages 214-216

For an example of the format of the notes in KEYS to SUCCESS in Medicine  that  are designed to aid studying and revision by facilitating understanding and memorising see link below:

Revision notes on Sarcoidosis

 

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