NBME 21

nbme21/Block 2/Question#19

A 3-year-old boy who recently immigrated to the USA ...

Increased proportions of osteoid

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submitted by hayayah(54),

This pt has osteomalacia / rickets (since he's a kiddo). Caused by defective mineralization of osteoid (osteomalacia) or cartilaginous growth plates (rickets, only in children).

Most commonly d/t Vitamin D deficiency.

Children with rickets have pathologic bow legs (genu varum), bead-like costochondral junctions (rachitic rosary), craniotabes (soft skull).

  • Dec. Vitamin D (normal function is to reabsorb Ca2+ and PO4)

  • Dec. serum Ca2+

  • Dec.  serum PO4

  • Inc. PTH