Osteomalacia - Ix + Mx

Question 1

Bloods;
U&Es: to screen for ? anomalies.
???: raised . indicating increased osteoblast activity.
Plasma ?: usually ?due to secondary hyperPTH, may be low.
Serum phosphate: ? due to PTH dependant ?.
Serum ? levels: high.
Serum 25-hydroxyvitamin D: ?.

Answer 1

renal
ALP
calcium
normal
low
phosphaturia
pth
low

Question 2

XR

Often ?, may show ‘ ? zones’ of defective mineralisation in ? bone, ? or ribs.
In children, the pathognomic feature is ? of the ? plate.

An ? ? ? may be necessary if tests do not confirm diagnosis.

Answer 2

normal
looser
long
pelvis
widening 
epiphyseal
iliac crest biopsy

Question 3

Treatment;
? vitamin D replacements, high dose for ? weeks then maintenance (? if
the issue is malabsoption, ? if the problem is renal/ hepatic disease).
The disease generally responds fairly ? to a restoration of ? ?

Answer 3

oral
4
iv
activated
rapid
vit d

Question 4

Rare causes of osteomalacia (rather than vitamin D deficiency) include ? (most commonly due to genetic abnormalities),
?, ? or ? intoxication

Answer 4

hypophosphataemia
bisphosphonates
fluoride
aluminium