MBD

Question 0

Hypercalcemia, metabolic alkalosis, renal insufficiency

Answer 0

Milk- alkali syndrome

Question 1

Hypophosphatemia, Renal phosphate wasting, inappropriately low 1, 25 D

Answer 1

Tumor induced osteomalacia

Question 2

Hypercalcemia, high calcitriol, low PTH, normal 25 OH D, and no granulomatous dz. responds to low dose glucocorticoids. May have high ACE.

Answer 2

Idiopathic calcitriol induced hypercalcemia.

Question 3

Idiopathic infantile hypercalcemia

Answer 3

Inactivating mutation of cyp24A1 (24 hydroxylase -which inactivates 1, 25 D and converts 25 D to inactive 24,25 D.
Can happen in adults as well but ACE normal.

Question 4

Familial hypocalciuric Hypercalcemia

Answer 4

AD inactivating mutation of CaSR gene: need higher serum ca to suppress PTH and to reduce ca re absorption in CTAL.
24 hr urine excretion<150mg
PTH high
Calcitriol nl
Hypercalcemia is not sensed by target organs like GI tract

Question 5

Subperiosteal re absorption
Bone cysts
Pathological fractures

Answer 5

Osteitis fibrosa cystic a

Question 6

Radio Lucent lesions. Bone cysts w thin sclerotic margins. Thickened rotator cuff or biceps synovial sheath
Congo red staining
Apple green birefringence under polarized light
Fat pad bx not useful

Answer 6

Dialysis related amyloid