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Flashcards in Bone Deck (16)
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1

what does PTH do?

increases CA
(dec in PO4)

- releases Ca from bone
-inc Ca absorp from gut
- inc Ca uptake from kidneys

2

what is the work up for short stature

cbc
liver and renal panel
ESR?CRP for implammatory
TTG to rule out celiac
TSH/FT4
carotene and folate for nutrition
Ca/mg/PO4
Urine - RTA
Bone age
Karyotype for a girl

(IGF 1/IGF BP3
porlactin)

3

what are the CF of hypocalcemia

asymptomatic
msl: intermittent muscle cramps - at rest or during exercise, laryngospasm, tetany
CNS: SZ, papillodema, basal ganglia calcifcation
H&N: cataract, enamel hypoplasia
CVS: QTc and ST prolongation, arrythmia, HB

4

what are common causes of Vit D def

Lack of dietary intake
Lack of sun exposure
liver disease
renal disease
drugs - phenytoin. phenobar
Vit D resistance

5

what are the 4 main causes of hypocalcemia

1. Vit D def
2. Malabsorption
3. hypoparathyroidism - congenital or acquired
4. pseudohypoparathyroidism - resistance to PTH

6

if pt has hypopartathyroidism, what will the PTH, Calcitriol, Ca and PO4 be

low PTH
low calcitriol
low Ca
high PO4

7

what are risk factors for Vit D def

exclusive BF
mothers that are Vit def
darker skin
poor sun exposure
northern communities

8

what are the 2 main groups of rickets?

hypocalcemic
hypophosphatemic

9

what are hypophosphatemic causes of rickets?

1) not enough PO4 going in: malnutrition, GI losses, antacids
2) too much out - congenital disorders, systemic illness

10

what are clinical features of rickets in the newborn

FTT
poor energy
muscle weakness
bone deformities and fractures

11

what are clinical features of Rickets

frontal bossing
craniotabes
delayed closure of fontanelles
rachitic rosaries
Harrison Groove
enlarged wrists and ankles
bowing

12

what are radiologic features of rickets

widening of distal ulna and radius
concave cupping
frayed and poorly demarcated ends
increased space of writs

13

what are the lab abnormalities of Vit D def

Vit D low
Low/N Ca
Low PO4
high PTH
high ALP

14

what is Albright hereditary osteodystrophy

pseudohypoparathyroidism - resistance to PTH
High PTH but LOW Ca

short stature, round facies with a low nasal bridge, obesity, disproportionate shortening of the limbs (particularly brachydactyly of the third, fourth, and fifth metacarpals and first distal phalanx), heterotopic ossification, and intellectual disability.

15

what are causes of early and late neonatal hypocalcemia?

Early - (birth to 4 days) = prematurity, maternal diabetes, perinatal asphyxia, and IUGR
Late - (5 to 10 days) = hyperphosphatemia, hypomagnesaemia, hypoparathyroidism, maternal vit D deficiency, and infantile osteopetrosis.

16

patient is seen for bowing of the legs.
BW phosphorus level is very low, but the PTH level is normal. Dx

X-linked hypophosphatemic rickets