Case Study by Daisy Stoner https://padlet.com/dai1800/6eut4s7jdk5u A 72-year-old woman, a chronic patient with Crohn’s disease, has taken oral prednisolone as part of her treatment for the last 6 months. Last night when she took her bath, fell on the tub and experienced a severe pain in her hip region. She was rushed to the hospital where a series of biochemical tests were made (See table for details). Radiological examination confirmed the presence of a fracture in the neck of the femur. What is the probable diagnosis? Justify any possible differential diagnosis. What further test(s) would request to confirm the diagnosis? Could you suggest a possible treatment? en-us 2015-12-30 12:30:06 UTC 2024-06-02 18:19:44 UTC hello@padlet.com dai1800 https://padlet.com/dai1800/6eut4s7jdk5u/wish/87381467 2015-12-30 12:34:56 UTC https://padlet.com/dai1800/6eut4s7jdk5u/wish/87381467 dai1800 https://padlet.com/dai1800/6eut4s7jdk5u/wish/87381606 2015-12-30 12:41:23 UTC https://padlet.com/dai1800/6eut4s7jdk5u/wish/87381606 Understanding the table dai1800 https://padlet.com/dai1800/6eut4s7jdk5u/wish/87381644 Calcium is low - explains fractured femur

Phosphate is a bit low

Protein is low

Albumin is a bit low

Alkaline phosphatase very high

Urea is fine

Creatinine is fine

Na is fine

K is fine

CO2 a bit low

]]> 2015-12-30 12:43:59 UTC https://padlet.com/dai1800/6eut4s7jdk5u/wish/87381644 CURRENT THEORY  dai1800 https://padlet.com/dai1800/6eut4s7jdk5u/wish/87382280 Osteomalacia - bone disease

explains calcium, phosphate and ALp levels

Protein/Albumin?

]]> 2015-12-30 13:20:25 UTC https://padlet.com/dai1800/6eut4s7jdk5u/wish/87382280 Metabolic bone disease in patients with inflammatory bowel disease dai1800 https://padlet.com/dai1800/6eut4s7jdk5u/wish/87387397 http://rheumatology.oxfordjournals.org/content/38/9/801.full

]]> 2015-12-30 17:38:55 UTC https://padlet.com/dai1800/6eut4s7jdk5u/wish/87387397 Reduced bone density in patients with inflammatory bowel disease. dai1800 https://padlet.com/dai1800/6eut4s7jdk5u/wish/87387504 http://gut.bmj.com/content/40/2/228.full.pdf+html

]]> 2015-12-30 17:43:08 UTC https://padlet.com/dai1800/6eut4s7jdk5u/wish/87387504 To research  dai1800 https://padlet.com/dai1800/6eut4s7jdk5u/wish/87387509 - protein levels

- why each test was performed

- treatment/prgnosis

]]> 2015-12-30 17:43:35 UTC https://padlet.com/dai1800/6eut4s7jdk5u/wish/87387509 Glucocorticoid-induced osteoporosis: who to treat with what agent? dai1800 https://padlet.com/dai1800/6eut4s7jdk5u/wish/87388030 http://www.ncbi.nlm.nih.gov/pubmed/25385412

]]> 2015-12-30 18:13:59 UTC https://padlet.com/dai1800/6eut4s7jdk5u/wish/87388030 Osteomalacia  dai1800 https://padlet.com/dai1800/6eut4s7jdk5u/wish/87388035 2015-12-30 18:14:22 UTC https://padlet.com/dai1800/6eut4s7jdk5u/wish/87388035 Osteoperosis - differential diagnosis  dai1800 https://padlet.com/dai1800/6eut4s7jdk5u/wish/87388040 2015-12-30 18:14:49 UTC https://padlet.com/dai1800/6eut4s7jdk5u/wish/87388040 Osteomalacia dai1800 https://padlet.com/dai1800/6eut4s7jdk5u/wish/87388177 http://www.sciencedirect.com/science/article/pii/S0263931906000512

good table to support why is OM rather than OP

]]> 2015-12-30 18:20:29 UTC https://padlet.com/dai1800/6eut4s7jdk5u/wish/87388177 Treatment / Prognosis dai1800 https://padlet.com/dai1800/6eut4s7jdk5u/wish/87388241 2015-12-30 18:23:09 UTC https://padlet.com/dai1800/6eut4s7jdk5u/wish/87388241 dai1800 https://padlet.com/dai1800/6eut4s7jdk5u/wish/87424599 determine the difference by

- bone biopsy

- vitamin D levels

- bone x-rays

- bone density tests

]]> 2016-01-02 10:58:48 UTC https://padlet.com/dai1800/6eut4s7jdk5u/wish/87424599 Treat with Vit D3 or phosphate dai1800 https://padlet.com/dai1800/6eut4s7jdk5u/wish/87424945 http://www.ncbi.nlm.nih.gov/pubmed/26205357

]]> 2016-01-02 11:18:35 UTC https://padlet.com/dai1800/6eut4s7jdk5u/wish/87424945 action of Vitamin D dai1800 https://padlet.com/dai1800/6eut4s7jdk5u/wish/87425081 http://www.ncbi.nlm.nih.gov/books/NBK278935/

]]> 2016-01-02 11:28:04 UTC https://padlet.com/dai1800/6eut4s7jdk5u/wish/87425081 Plan  dai1800 https://padlet.com/dai1800/6eut4s7jdk5u/wish/87425347 - Introduction

- Osteomalacia

- Tests - what they show/don't show

- Osteoperosis

- Further testing

- Treatment/Prognosis

]]> 2016-01-02 11:45:22 UTC https://padlet.com/dai1800/6eut4s7jdk5u/wish/87425347 Tests dai1800 https://padlet.com/dai1800/6eut4s7jdk5u/wish/87489435 2016-01-04 08:30:20 UTC https://padlet.com/dai1800/6eut4s7jdk5u/wish/87489435 Tests dai1800 https://padlet.com/dai1800/6eut4s7jdk5u/wish/87489459 2016-01-04 08:30:36 UTC https://padlet.com/dai1800/6eut4s7jdk5u/wish/87489459 Calcium  dai1800 https://padlet.com/dai1800/6eut4s7jdk5u/wish/87489484 http://ac.els-cdn.com/S0950351X97805691/1-s2.0-S0950351X97805691-main.pdf?_tid=7ed9affc-b2c0-11e5-bad3-00000aab0f6c&acdnat=1451897733_3c198e6077f466117e1047ad209d27b9

]]> 2016-01-04 08:30:57 UTC https://padlet.com/dai1800/6eut4s7jdk5u/wish/87489484 Phosphate dai1800 https://padlet.com/dai1800/6eut4s7jdk5u/wish/87489511 2016-01-04 08:31:17 UTC https://padlet.com/dai1800/6eut4s7jdk5u/wish/87489511 Protein dai1800 https://padlet.com/dai1800/6eut4s7jdk5u/wish/87489518 2016-01-04 08:31:25 UTC https://padlet.com/dai1800/6eut4s7jdk5u/wish/87489518 Albumin dai1800 https://padlet.com/dai1800/6eut4s7jdk5u/wish/87489539 2016-01-04 08:31:44 UTC https://padlet.com/dai1800/6eut4s7jdk5u/wish/87489539 Alkaline phosphatase  dai1800 https://padlet.com/dai1800/6eut4s7jdk5u/wish/87489557 2016-01-04 08:31:57 UTC https://padlet.com/dai1800/6eut4s7jdk5u/wish/87489557