COPD USMLE Step 1 Practice Question
A 35-year-old African American woman presents with a 3-week dry cough, fatigue, and painful red nodules on her anterior shins. Vital signs: BP 118/76, HR 88, RR 16, Temp 37.2°C, SpO2 98% on room air. Chest radiograph reveals bilateral hilar lymphadenopathy. Serum calcium is 11.2 mg/dL (normal 8.5-10.2). She denies fever. Laboratory studies show normal parathyroid hormone levels. Which of the following best explains her hypercalcemia mechanism?
Answer choices
- AReduced calcitonin secretion from parafollicular cells
- BParathyroid hormone related peptide secretion by a squamous cell carcinoma
- CExcess vitamin D intake due to malabsorption treatment
- DMetastatic osteolysis from small cell carcinoma
- EIncreased 1 alpha hydroxylase activity in macrophages within granulomasCorrect answer
- FIncreased osteoclastic activity due to RANKL secretion by activated T lymphocytes
See the full explanation
Get the correct-answer rationale, why each distractor is wrong, the underlying mechanism, and high-yield associations — plus adaptive practice that targets your weak areas — with a free MedBoardPRO account.