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Riddler Q5


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Riddler Q5

  1. 1. Riddler #4 <ul><li>A 38 y/o homeless male is found down. In the ED he is inebriated, blood alcohol level is 200. His serum calcium is 5.5 with an albumin of 2.7 and his magnesium was 0.7. Exam was consistent with hypocalcemia. </li></ul><ul><ul><li>-Explain why hypomagnesemia is associated with hypocalcemia? (be specific) 2 pts. </li></ul></ul>
  2. 2. Riddler #4 Answer <ul><li>Magnesium depletion causes hypocalcemia: </li></ul><ul><ul><li>PTH resistance, which occurs when serum magnesium concentrations fall below 0.8 meq/L (1 mg/dL or 0.4 mmol/L). </li></ul></ul><ul><ul><li>Decreased PTH secretion, which occurs in patients with more severe hypomagnesemia. </li></ul></ul><ul><li>Note: Severe hypermagnesemia , a very rare disorder, also can cause hypocalcemia, by suppressing the secretion of PTH. >6mg/dl. Usually only seen with treatment of Eclampsia </li></ul>
  3. 3. Riddler #5 <ul><li>20 y/o female in her 1 st trimester, is referred to you for progressive dyspnea. An echo reveals severe pulmonary hypertension. Right Ventricular systolic pressure is 90 with a systemic pressure of 110 mm hg. No PE and no intracardiac shunt. </li></ul>
  4. 4. Riddler #5 <ul><li>Which of the following is associated with the lowest risk of Maternal Mortality? </li></ul><ul><li>A) Termination of pregnancy </li></ul><ul><li>B) Initiation of prostacyclin therapy </li></ul><ul><li>C) Initiation of bosentan therapy </li></ul><ul><li>D) Initiation of anticoagulation therapy </li></ul><ul><li>E) Initiation of ACE inhibitor therapy </li></ul><ul><li>Bonus: Two points: What Super Bowl did Doug Williams win and who received the 80 yard bomb pass from him during the game? </li></ul>