A 64-year-old man arrives at the office exhausted. He has high blood pressure and poorly controlled diabetes, which is exacerbated by nephropathy and peripheral neuropathy. His renal function has steadily deteriorated over the last few years. His conjunctivae are pale, and he has bilateral 1+ peripheral edema. The following are the laboratory results: 11ec160b 3a2e f5c4 9249 eb513667f5c6 MD0001 00 The normal relationship between serum concentrations of free calcium and parathyroid hormone is depicted in area "C" of the graph below. Which of the following areas most likely represents this patient's current metabolic state?

Question

A 64-year-old man arrives at the office exhausted. He has high blood pressure and poorly controlled diabetes, which is exacerbated by nephropathy and peripheral neuropathy. His renal function has steadily deteriorated over the last few years. His conjunctivae are pale, and he has bilateral 1+ peripheral edema. The following are the laboratory results: 11ec160b 3a2e f5c4 9249 eb513667f5c6 MD0001 00 The normal relationship between serum concentrations of free calcium and parathyroid hormone is depicted in area "C" of the graph below.   Which of the following areas most likely represents this patient's current metabolic state?

Quizplus · Accepted Answer

Eductional Objective: Hyperphosphatemia (binding serum Ca²⁺+) and low 1,25-dihydroxyvitamin D (decreases intestinal Ca²⁺+ absorption and Ca²⁺+ release from bone) are common symptoms of chronic kidney disease. The resulting hypocalcemia stimulates parathyroid hormone release, resulting in secondary hyperparathyroidism.

A 64-Year-Old Man Arrives at the Office Exhausted