Excess Vitamin D


Excess Vitamin D


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USMLE® Step 1 questions

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Excess Vitamin D

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USMLE® Step 1 style questions USMLE

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A 29-year-old woman is brought to the emergency department by her partner for evaluation of progressive confusion. She also complains of nausea and vomiting for the past 24-hours. Past medical history is significant for asthma and a chronic cough for the past year. The patient has had 2 episodes of uveitis in the past 6 months treated with topical therapy. Current medications include vitamin supplementation and inhaled albuterol as needed. Family history is noncontributory. She does not use tobacco, alcohol, or illicit drugs. Temperature is 37.2 C (98.9 F), pulse is 98/min, respirations are 18/min and blood pressure is 100/60 mmHg. Physical examination shows dry mucous membranes and multiple tender pink-to-reddish nodules below the knee. Chest x-ray shows bilateral hilar lymphadenopathy. Laboratory studies are performed and shown below:  
Laboratory value  Result 
Serum chemistry 
Sodium   132 mEq/L 
 Potassium   4.2 mEq/L 
 Chloride   95 mEq/L 
 Calcium  11.8 mg/dL 
 Creatinine   0.8 mg/dL 
 Blood urea nitrogen  20 mg/dL 

Serum ACE levels are increased. HIV testing is negative. Which of the following serum substance levels is most likely to be increased in this patient?

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Granulomatous disease p. 209

hypervitaminosis D with p. 474

Hypervitaminosis D p. 474

Sarcoidosis p. 701

hypervitaminosis D p. 474

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Excess vitamin D or hypervitaminosis D refers to the toxic effects of overconsumption of vitamin D. It can cause too much calcium to be absorbed from the intestines, leading to a buildup of calcium in the blood (hypercalcemia). This can damage the heart, kidneys, and other organs. Symptoms of excess vitamin D include nausea, vomiting, weakness, and stupor.


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