Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Gastrointestinal > Vitamin D deficiency and Osteomalacia > Flashcards

Vitamin D deficiency and Osteomalacia Flashcards

1
Q

What is Osteomalacia?

A

Disorder of mineralisation of bone matrix (osteoid)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is Rickets?

A

Disroder of defective mineralisation of cartilage in the epiphyseal growth plates of children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the risk factors for Vitamin D Deficiency?

A

Lack of exposure to sunlight
Dietary Deficiency
Malabsorption
Decreased 25-hydroxylation of Vitamin D (due to liver disease, anticonvulsants)
Decreased 1a-hydroxylation of Vitamin D (due to chronic kidney disease, hypoparathyroidism)
Vitamin D Resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are some Renal Phosphate Wasting Disorders?

A

Fanconi’s Syndrome
Renal Tubular Acidosis
Hereditary Hypophosphataemic rickets (X-linked or autosomal dominant)
Tumour induced osteomalacia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is Fanconi’s Syndrome characterised by?

A

Phosphaturia
Glycosuria
Amino Aciduria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the epidemiology of Vitamin Deficiency and Osteomalacia?

A

Common in industrialised countries

More common in females

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the presenting symptoms of Osteomalacia?

A

Bone pain (mainly in the axial skeleton)
Weakness
Malaise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the presenting symptoms of Rickets?

A

Hypotonia
Growth retardation
Skeletal deformities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the signs of Osteomalacia on physical examination?

A

Bone tenderness
Proximal Muscle weakness
Waddling gait
Signs of hypocalcaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the signs of Hypocalcaemia on physical examination?

A

Trousseau’s Sign

Chvostek’s Sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is Trousseau’s Sign?

A

Inflation of a blood pressure cuff to above the systolic pressure for > 3 mins causes tetanic spasm of the wrist and fingers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is Chvostek’s Sign?

A

Tapping over the facial nerve causes twitching of the ipsilateral facial muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the signs of Rickets on physical examination?

A 
Bossing of frontal and parietal bones 
Swelling of costochondral junctions (rickety rosary)
Bow legs in early childhood
'Knock Knees' in later childhood
Short Stature
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What bloods would you do for Vitamin Deficiency and Osteomalacia and what might you expect?

A 
Low or normal Ca2+
Low phosphate 
High ALP
Low 25-hydroxy Vitamin D 
High PTH (secondary hyperparathyroidism)
Check U&Es 
Check ABGs (for renal tubular acidosis)
Increased phosphate excreting (in renal phosphate wasting)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What might you see on Radiographs for Vitamin Deficiency and Osteomalacia?

A

May appear normal
May show osteopaenia
Looser’s Zones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are Looser’s Zones?

A

Wide transverse lucencies transversing part way through a bone, usually at right angles to the involved cortex and are associated most frequently with osteomalacia and rickets (aka pseudofractures)

17
Q

What other investigation might you want to do for Vitamin Deficiency and Osteomalacia?

A

Bone biopsy after double tetracycline labelling

18
Q

How does bone biopsy after double tetracycline labelling work?

A

Tetracycline is deposited at the mineralisation front as a band
After two course of tetracycline (separated by a few days), the distance between the bands of deposited tetracycline is reduced in osteomalacia
Not usually necessary for the diagnosis of osteomalacia

19
Q

What is the management plan for Vitamin Deficiency and Osteomalacia?

A

Vitamin D and calcium replacement
Monitoring
Treat the underlying cause

20
Q

What do we monitor in the management of Vitamin Deficiency and Osteomalacia?

A 
24 Urinary Calcium
Serum Calcium
Phosphate 
ALP
PTH
Vitamin D
21
Q

What are the possible complications of Vitamin Deficiency and Osteomalacia?

A 
Bone deformities 
Hypocalcaemia can cause epileptic seizures 
Cardiac arrhythmias 
Hypocalcaemic tetany 
Depression 
Hypocalcaemia symptoms
22
Q

What is the way to remember Hypocalcaemia symptoms?

A

CATs go NUMB

Convulsions
Arrhythmias
Tetany
NUMBness/paraesthesia

23
Q

What is the prognosis for patients with Vitamin Deficiency and Osteomalacia?

A

Symptoms and radiological appearances improve with Vitamin D treatment
Bone deformities in children tend to be permanent

Gastrointestinal (61 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions