Disorders of calcium + bone metabolism

Question 1

What problem is indicated if calcium and phosphate are going in the same direction?

Answer 1

vitamin D problem

both low = vit D deficiency
both high = vit D excess

Question 2

What problem is indicated if calcium and phosphate are going in opposite directions?

Answer 2

PTH problem

Question 3

What does vitamin D deficiency in children put the children at risk of?

Answer 3

rickets

Question 4

What is Vitamin D deficiency that affects the bones called in adults?

Answer 4

osteomalacia

Question 5

What causes osteomalacia?

Answer 5

vitamin D deficiency
metabolic bone disease where there is inadequate mineralisation of the bony osteoid

Question 6

Osteomalacia symptoms/signs

Answer 6

bone pain
myopathy
Looser’s zones - pseudofractures
biochemical abnormality
increased fracture risk

Question 7

Rickets signs/symptoms

Answer 7

bowed legs
costochondral swelling
widened epiphyses at the wrists
myopathy

Question 8

What is osteoporosis?

Answer 8

reduction in the amount of bony tissue within the skeleton

Question 9

Why may osteoporosis arise?

Answer 9

failure to lay down sufficient bone during growth (peak bone mass)

earlier than usual onset of bone loss

increased rates of bone loss later in life

Question 10

What T score would diagnose osteoporosis?

Answer 10

<-2.5

Question 11

Osteoporosis treatments

Answer 11

lifestyle - stop smoking, do weight bearing exercise, reduce alcohol

bisphosphonates
vitamin D/Ca
denosumab
PTH derivative - Teriparatide
oestrogens - HRT

Question 12

Bone profile results in primary hyperparathyroidism

Answer 12

high/N PTH
high calcium
low phosphate
high/N ALP
Vit D Normal

Question 13

Bone profile results in rickets/osteomalacia

Answer 13

low vitamin D
low/normal Ca
low phosphate
high PTH
high ALP

Question 14

Bone profile results in osteoporosis

Answer 14

Normal Ca
Normal Phosphate
Normal PTH
Normal ALP
Normal Vit D