Hyper Vit D

Question 1

Who is most susceptible to HVD?

Answer 1

Those with preexisting renal or GI dysfunction

Question 2

When to acute clinical manifestations appear?

Answer 2

3-9 days after massive doses

(4-18 million units/day)

Question 3

Sx of acute HVD?

Answer 3

Vomiting, fever, dehydration, abdominal craps, bone pain and tenderness, convulsions, coma.

Question 4

Sx of chronic HVD?

Answer 4

Lassitude, thirst, anorexia, polyuria

followed by:

vomiting, abdominal pain, diarrhea

Question 5

Labs in HVD?

Answer 5

Albuminuria, hematuria, hypercalciuria, hypercalcemia

(with onset of renal insufficiency, levels of serum Phosphorus and nonprotein nitrogen are elevated)

Question 6

Radiographic findings in infants and children with HVD?

Answer 6

Metaphyseal bands of increased density, alternating with areas of increased lucency.

Cortical thickening (periosteal apposition) and Cortical thinning in different places

Widespread osteosclerosis has been noted

Metastatic calcification of soft tissues structures (viscera, blood vescels, periarticular, muscles, laryngeal/tracheal cartilage, falx & tentorium)

Question 7

Radiographic findings in adults with HVD?

Answer 7

Focal or generalized osteoporosis.

Massive soft tissue calcification

Masses of Ca in periarticular regions

Question 8

Metastatic soft tissue calcification DDX?

Answer 8

HyperVit D

Milk-alkali

HPT

Myeloma

Skeletal Mets

Injury

Collagen vascualr disorders

Tumoral calcinosis