Question

The patient is a 22-year-old male who was admitted to the hospital for a spiral fracture of his right fibula. Patient history revealed a sedentary lifestyle with poor nutritional habits. He is a focused university student who studies 18 hours a day and eats very little when stressed. For the last three weeks, he reported general weakness and body pains. The trauma occurred when he jumped down three stairs while running to his final exam before Christmas. The physician was concerned about potential physiological factors weakening the bone and ordered blood tests and a hormone panel. The results of the blood report are shown below: Calcium -- LOW Bone alkaline phosphatase (ALP-2) -- ELEVATED Adrenocorticotropin (ACTH) -- NORMAL Aldosterone (Normal Sodium Diet Adult) -- NORMAL Cortisol -- NORMAL Calcitonin -- NORMAL Parathyroid Hormone (PTH) -- ELEVATED Thyroxine (T4 free serum) -- NORMAL Thyroid-Stimulating Hormone (TSH) -- NORMAL Vitamin D - Cholecalciferol -- LOW Insulin -- NORMAL Glucagon -- NORMAL QUESTIONS 1. How are the blood results different from normal? 2. Which hormones are related to this system? What does each one do? 3. Which glands could be responsible for this dysregulation? Explain. 4. How does alkaline phosphatase relate to this system? 5. What is the significance of the calcium blood test results? 6. What is the significance of the ALP-2 test results? 7. What is your final diagnosis? Explain exactly what you think is happening in this patient.

The patient is a 22-year-old male who was admitted to the hospital for a spiral fracture of his right fibula. Patient history revealed a sedentary lifestyle with poor nutritional habits. He is a focused university student who studies 18 hours a day and eats very little when stressed. For the last three weeks, he reported general weakness and body pains. The trauma occurred when he jumped down three stairs while running to his final exam before Christmas. The physician was concerned about potential physiological factors weakening the bone and ordered blood tests and a hormone panel. The results of the blood report are shown below:

Calcium -- LOW
Bone alkaline phosphatase (ALP-2) -- ELEVATED
Adrenocorticotropin (ACTH) -- NORMAL
Aldosterone (Normal Sodium Diet Adult) -- NORMAL
Cortisol -- NORMAL
Calcitonin -- NORMAL
Parathyroid Hormone (PTH) -- ELEVATED
Thyroxine (T4 free serum) -- NORMAL
Thyroid-Stimulating Hormone (TSH) -- NORMAL
Vitamin D - Cholecalciferol -- LOW
Insulin -- NORMAL
Glucagon -- NORMAL

QUESTIONS
1. How are the blood results different from normal?
2. Which hormones are related to this system? What does each one do?
3. Which glands could be responsible for this dysregulation? Explain.
4. How does alkaline phosphatase relate to this system?
5. What is the significance of the calcium blood test results?
6. What is the significance of the ALP-2 test results?
7. What is your final diagnosis? Explain exactly what you think is happening in this patient.

Added by Grant P.

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