Dear Students,

Thought to explain the underlying principle on Q 9 we went over in our clicker for Endocrine week 1 but did not discuss fully as we ran out of time. It is very critical to grasp this concept for our Physio Exam 2, board exam, and for future clinical practice. 

Diagnosis: Chronic Renal Failure (CRF)/ Chronic Kidney Disease (CKD) 

Mechanism: 1,25 DHCC (Dihydroxycholecalciferol) - Active Principle of VIt. D's synthesis from 25-hydroxycholecalciferol (Liver) by an enzyme 1-alpha hydroxylase in the kidney will be compromised and henceforth calcium won't be absorbed from the intestine and reabsorbed from kidney tubules -- leads to hypocalcemia (decreased serum calcium) 

The reason patient exhibits hyperlipidemia (will lead to lipiduria eventually- excretion of lipids in urine from kidneys) as there is a compensatory increase in lipoproteins (one of the plasma proteins) production from liver as patient will end up losing plenty of plasma proteins through the diseased kidneys (loss of negative charges , increase in pore size of the filtration barrier etc..). Lipids are a part of plasma lipoproteins! 

I hope this will help if not feel free to contact me in-person. 

Dr. Shah