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  #1  
Old 12-22-2011
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Question Bone pain, muscle weakness, abdominal distension!

25 yr old woman with generalized bone pains and frequent episodes of loose bulky stools with abdominal distension and muscle weakness. X rays show generalized bone demineralization. What would be the level of the following in terms of increase and decrease?

1. Calcium
2. Alkaline phosphatase
3. Phosphorous
4. PTH
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  #2  
Old 12-22-2011
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↑, ↑, ↓, ↑
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drortho (01-17-2012), indigo (12-22-2011)
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Old 12-22-2011
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Thats correct man,but why should the ALP increase?
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Old 12-22-2011
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Quote:
Originally Posted by indigo View Post
Thats correct man,but why should the ALP increase?
Whenever Osteoblastic activity increases Alkaline Phosphatase also increases.
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Old 12-22-2011
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she obviously has Vitamin D deficiency(fat soluble vitamin), but why is the calcium high?...thot low calcium will be responsible for the increase in PTH which trashes the phosphate, and PTH increases alkaline phospate(ALP) cos it acts on OSTEOBLASTS (which secrete ALP and rank ligand)...

please address the calcium issue...dont want to get it twisted
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Old 12-22-2011
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Calcium is low,ALP is high Phosporous low and PTH is high
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Old 12-22-2011
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Actually here why would the osteoblastic activity increase?
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Old 12-22-2011
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look at my post @ indigo...Increase in PTH leads to a direct stimulation of OSTEOBLASTS (which secrete ALP and also RANK-ligand) . the overall effect of increased PTH is increased ALP (via osteoblast stimulation)and then increased OSTEOCLASTIC acitivity(via increased expression of RANK-ligand by osteoblast.)

OSTEOCLAST-have RANK receptors which respond to the RANK-ligand on the osteoblasts...

PTH do not act directly on OSTEOCLASTS...can only do so via the osteoblasts
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