Osteomalacia - week 13 PBL

Question 1

What is osteomalacia?

Answer 1

Weak and soft bones due to Vit D deficiency

Question 2

Who is likely to get osteomalacia?

Answer 2

Vit D deficiency in diet and sunlight
Pts with malabsorption disorders

Question 3

What is the pathophysiology of osteomalacia?

Answer 3

Chronic secondary hyperparathyroidism

Sustains PTH = normal ca serum levels = increased bone resorption = phosphates released = raised PTH = osteoblast activity

New bone formation but matrix not mineralised

Question 4

Presentation of osteomalacia?

Vit D deficiency

Fractures
Low mineral bone density
Bone pain
General malaise
Waddling gait
Cannot stand from a squat unaided, or easily get up from a chair

Question 5

Investigation for osteomalacia?

Answer 5

Serum 25(OH) Vit D (undetectable)
PTH (elevated),
Ca (normal unless advanced disease)
Phosphate (low),
ALP (raised)
X-rays

Question 6

Management and prognosis of osteomalacia?

Answer 6

Vit D
10,000 and 25,000 IU daily for 2-4 weeks
Then 800-1600 IU