Hyper Vit A

Question 1

Sx of acute HVA?

Answer 1

Vertigo

HA

Nausea & vomiting

Drowsiness

Irritability

Buldging of fontanelles

Question 2

Features of buldging fontanelles in HVA?

Answer 2

Appears within 12 hrs

disappears within 36-48hours after dosage

(related to increase production and decreased absorption of CSF)

Question 3

Sx of chronic HVA?

Answer 3

Young and old non-specific early finding: anorexia and itching

Weeks to months: Hard & Tender soft tissue nodules in the extremities (forearms MC)

Dry scaly skin

coarse & sparse hair

hepatosplenomegaly

digital clubbing

Question 4

Diagnostic lab for HVA?

Answer 4

elevated serum Vit A concentration

Question 5

Radiographic signs of HVA?

Answer 5

Only seen in children

Cortical thickening

Hyperostosis in ulnae and metatarsals (wavy/undulating diaphysis)

Ocassionally the clavicles, tibiae and fibulae are affected as well

+ bone scan in areas of hyperostosis

Question 6

Findings in HVA at distal ends of the femora?

Answer 6

May show: cupping shortening and splaying of metaphyses

Irregularity & narrowing of the growth plates

Hypertrophy and premature fusion of the epiphyseal ossification centers

Question 7

Findings in chronic HVA in first 6mo of life?

Answer 7

Poorly mineralized skull

dense sutural margins

widening of the sutures with elongation of the head

hyperostosis in the occipital and temoral bones

ventricular dilation

Question 8

Syndrome mimicking chronic HVA?

Answer 8

Infantile cortical hyperostosis

ICH affects mandible and skull more

HVA affects matatarsals more