re: OB Cooking and Drinking Thread, Medical questions edition

Those were the days.

I don't think Larson on roids could hit 20 homers with these wet newspapers.

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Give me another board question, trying to impress my Rn wife, might talk her into a pelvic exam.

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Yeah...just wait til the answer's posted again and claim your victory.

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Oh well. Arkys pitching was outstanding. We couldn't touch them.

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I just wish our offense was better. Oh well, can't have everything. I just hate seeing all the called third strikes they seem to take.

Yeah can't complain too much, we're just spoiled

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Yeah can't complain too much, we're just spoiled

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You can always complain. That's half the fun.

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Give me another board question, trying to impress my Rn wife

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Switched over to Endocrine questions so we'll up the intensity

Asymptomatic 72 y/o woman is evaluated after results of screening laboratory studies show hypercalcemia. Her only medication is calcium carbonate. On physical examination, vital signs are normal and BMI is 24. There are no masses palpable in the neck.

Laboratory studies:
Albumin 4.2 g/dL (42 g/L)
Calcium, total 10.9 mg/dL (2.73 mmol/L)
Creatinine 1.0 mg/dL (88.4 µmol/L)
Parathyroid hormone 178 pg/mL (178 ng/L)
Urine calcium 120 mg/24 h (3 mmol/24 h)

A technetium Tc 99m sestamibi scan and ultrasound of the neck both show a 1.5-cm enlarged mass in the right tracheoesophageal groove. Results of dual-energy x-ray absorptiometry show T scores of –2.2 in the femoral neck and –1.5 in the lumbar spine.

Which of the following is the most appropriate next step in management?
A Biopsy of the neck mass
B Measurement of the 1,25-dihydroxy vitamin D level
C Measurement of the 25-hydroxy vitamin D level
D Parathyroidectomy

*To the docs, let him answer first and test this hypothesis

Gotta be herpes.

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HIV

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Always in the differential diagnoses along with syphilis, cancer, and pulmonary embolus

I've had 2/3 of those.