(Q) What's your diagnosis?
(Q) What investigations would you request ?
(Q) How would you treat this patient?
Answers :
(1) Diagnosis :Rickets based on the physical signs .
(2) The investigations are :
Serum calcium : decreased
Serum phosphorus (PO4) :Decreased
Serum parathyroid hormone (PTH) :increase in response to hypocalcemia .
Serum 25(OH) Vit.D level : decrease
(3) X-ray of the radius and ulna :
Metaphysis are widened -Irregular and cupped -demenelalized bone
(4) Treatment of rickets due to Vit.D deficiency are:
Diet rich in vit.D - Increased exposure to sunlight
Supplementing vit. D and calcium
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