A 58-year-old obese woman with hypertension, type 2 diabetes, and chronic kidney

Question

A 58-year-old obese woman with hypertension, type 2 diabetes, and chronic kidney disease is admitted to hospital after a right femoral neck fracture sustained in a fall. Recently, she has been complaining of fatigue and was started on epoetin alfa (erythropoietin) subcutaneous injections. Her other medications include an angiotensin-converting enzyme inhibitor, a -blocker, a diuretic, calcium supplementation, and insulin. On review of systems, she reports mild tingling in her lower extremities. On examination, her blood pressure is 148/60 mm Hg. She is oriented and able to answer questions appropriately. There is no evidence of jugular venous distention or pericardial friction rub. Analyze this case study and answer the next two questions that follow.

Which of the following is true of the pathogenesis of bone disease in chronic kidney disease? (select all that apply)

Why was erythropoietin therapy initiated? (select all that apply)

In this patient, calcium is poorly absorbed from the gut because of decreased renally generated vitamin 1,25-(OH)2 D3 levels.

Explanation / Answer

FIRST QUESTION answer is

first option - In this patient, calcium is poorly absorbed from the gut because of decreased renally generated vitamin 1,25-(OH)2 D3 levels.

reason is patient has been giving calcium from outside so it ruled out other three possibilities in options of low calcium/osteoporosis.

SECOND QUESTION ANSWER IS

fourth option

This treatment is used to treat anemia seen in chronic kidney disease.

REASON is in fatigue condition and no movement of body further to fracture , blood is required for activity in muscles fatigue.

This treatment is used to treat anemia seen in chronic kidney disease.

REASON is in fatigue condition and no movement of body further to fracture , blood is required for activity in muscles fatigue.

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