Osteomalacia and Rickets Flashcards
underlying problem
insufficient vitamin D leads to defective bone mineralisation
presentation of osteomalacia
weak bones
bone pain
muscle weakness
pathological fractures
how is vitamin D made?
from cholesterol by the skin in response to UV radiation
groups vitamin D deficiency is more common in
darker skin
reduced sun exposure
malabsorption eg IBD
chronic kidney disease
What is vitamin D essential for?
calcium and phosphate absorption from intestines and kidneys
bone turnover regulation
inadequate vitamin D does what to calcium and phosphate?
lack in the blood
low levels lead to defective bone mineralisation
what does low calcium result in?
secondary hyperparathyroidism
hyperparathyroidism
parathyroid hormone tries to raise calcium level
increased reabsorption from bones
Lab investigation for vitamin D
serum 25-hydroxyvitaminD
other investigations and their findings
serum calcium and phosphate low serum alkaline phosphatase may be high parathyroid hormone may be high x-rays may show osteopenia DEXA - low mineral density
treatment
vitamin D
50 000IU once weekly for 6 weeks - initial
800 IU maintenance dose
what foods are a source of vitamin D?
eggs
oily fish
fortified cereals
nutritional supplements
hereditary rickets
rare
x linked dominant
low phosphate
rickets symptoms
lethargy bone pain swollen wrists bone deformity poor growth dental problems muscle weakness pathological fractures
bone deformities in rickets
bowing legs knock knees rachitic rosary craniotabes delayed teeth
