Metabolic Diseases

Question 1

Osteoporosis

Answer 1

reduced bone mass of normal quality; related to imbalance between osteoclastic and osteoblastic activity favoring osteoclastic resorption; serum calcium, phosphorus and alkaline phosphatrrse typically normal; generalized osteopenia with fractures frequent

Question 2

Osteomalacia/Rickets

Answer 2

related to deficiency of calcium, vitamin D or phosphorus with multitude of causes including dietary deficiency, malabsorption, liver disease and renal disease; abundance of unmineralized osteoid resulting in bone softening disease and osteopenia including pseudofractures; rickets in the child with radiographic findings including loss of zone of provisional calcification

Question 3

Hypophosphatemia

Answer 3

renal disease acquired or genetic resulting in Ph deficiency and leading to osteomalacia/rickets (vitamin D resistant osteomalacia/rickets)

Question 4

Hyperparathyroidism

Answer 4

Primary - related to parathyroid tumor or hyperplasia
Secondary- related to renal disease or GI malabsorption
Tertiary - related to ectopic autonomous functioning tissue or chronic secondary HPT
Radiographic findings related to increased osteoclastic activity with localized resorption including subperiosteal at middle phalanges pathognomonic

Question 5

Hypoparathyroidism

Answer 5

acquired related to accidental removal/damage to parathyroid glands during thyroid surgery, radiation, infection, carcinoma; hypocalcemia
and hyperphosphatemia; radiographic finding is osteosclerosis as well as calvarial thickening and hypoplastic dentition, may be associated with extensive calcification of spinal ligaments and basal ganglia calcification

Question 6

Pseudohypoparathyroidism: (PHP

Answer 6

genetic disorder related to end organ resistance to parathyroid hormone with normal parathyroid hormone production; characteristic somatotype of short stature, obesity, round face, brachydactyly, abnormal dentition and mental retardation; radiographic findings similar to hypoparathyroidism; hypocalcemia and hyperphosphatemia

Question 7

Pseudopseudohypoparathyroidism

Answer 7

(PPHP) genetic disorder similar to PHP and frequently a sibling of; is the normal calcium and phosphorus version of PHP; produce and respond to parathyroid hormone; same somatotype and radiographic findings

Question 8

Hypophosphatasia

Answer 8

Hypophosphatasia

Question 9

Hypovitaminosis C (scurvy):

Answer 9

deficiency of vitamin C resulting in decreased ability to produce collagen with inadequate osteoid formation; is a form of osteoporosis; adult form identical to adult osteoporosis; childhood form changes at the bone and are characteristic with proper names