Rickets mcq step 1 oblige?
A 5-year old child is brought by his parents to see a pediatrician. They tell the doctor that their child complains of bilateral leg pain and he have a waddling gait. Additionally, his legs are bowed outward, which has become more pronounced during the last year. Further examination reveals that the parents have been traveling in Asia during the finishing year and the family is strictly vegan (they do not consume meat or any milk products). The pediatrician suspects the child has rickets. This disease is characterized by which of the following change in his bones?
A. Decreased osteoblasts
B. Increased osteoclast activity
C. Increased osteoid
D. Marrow fibrosis
E. Sparse bony trabeculae
Answers:
I would reflect on the answer would be B... although indirectly increased. With low serum calcium the parathyroid glands would sense the low [Ca] and thus would release PTH. PTH acts on osteoblasts to secret RANKL which would activate osteoclast entertainment.. Incidentally you would have low phosphate, low calcium, low mineralization of osteoid (bone formation) and thus an osteomalacia-like picture...
It's strange though because I had a similar question on a qbank and the explanation said that osteoclast hustle and bustle is normal yet they go on to explain that within is an increase in bone resorption calcium due to the PTH release in Ricketts... that sounds contradictory to me...
EDIT
I just read the guy above me... trabeculae is wrong because this disease is inherently a disease of hypomineralization due to Vit D defficiency... bony trabeculae are see in and around the cancellous bone which would also be hypomineralized...
I still believe B is the "better" answer
I would try E. Sparse bony trabeculae Source(s): http://archaeozoo.wordpress.com/2007/11/…
These are some seriously simple questions and they are the remarkably "basics" of the beginning of medical school. You're going to be in big trouble when it comes time to taking exams. Much more when it comes to the boards.
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A. Decreased osteoblasts
B. Increased osteoclast activity
C. Increased osteoid
D. Marrow fibrosis
E. Sparse bony trabeculae
Answers:
I would reflect on the answer would be B... although indirectly increased. With low serum calcium the parathyroid glands would sense the low [Ca] and thus would release PTH. PTH acts on osteoblasts to secret RANKL which would activate osteoclast entertainment.. Incidentally you would have low phosphate, low calcium, low mineralization of osteoid (bone formation) and thus an osteomalacia-like picture...
It's strange though because I had a similar question on a qbank and the explanation said that osteoclast hustle and bustle is normal yet they go on to explain that within is an increase in bone resorption calcium due to the PTH release in Ricketts... that sounds contradictory to me...
EDIT
I just read the guy above me... trabeculae is wrong because this disease is inherently a disease of hypomineralization due to Vit D defficiency... bony trabeculae are see in and around the cancellous bone which would also be hypomineralized...
I still believe B is the "better" answer
I would try E. Sparse bony trabeculae Source(s): http://archaeozoo.wordpress.com/2007/11/…
These are some seriously simple questions and they are the remarkably "basics" of the beginning of medical school. You're going to be in big trouble when it comes time to taking exams. Much more when it comes to the boards.
Related Questions: