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  #1  
Old 01-05-2012
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Biochemistry Which Vitamin deficiency in Bowed legs

A 14-month-old baby boy is brought to your office by his mother because he seems to be in pain whenever he tries to move. During your physical examination you note bowing of his legs, depression of the sternum with outward projection of the ends of the ribs, reluctance to move his limbs, and numerous bruises on his legs as well as gingival hemorrhages. These findings lead you to suspect that this child suffers from a dietary deficiency of which of the following vitamins?

A. A
B. B1 (thiamine)
C. B12 (cyanocobalamin)
D. C (ascorbate)
E. D (calciferol)
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Ans E. Vitamin D

the patient has rickets. deficiency of vit D presents as bowing of bones, rachitic rosary (beading of ribs) and muscle weakness (floppy baby)

but bruising and gingival haemorrhage is making me confused.
i still go with E.
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.................................................. .......

Vit-C
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E. D (calciferol) deficiency ricket
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Quote:
Originally Posted by MedicalExaminer View Post
.................................................. .......

Vit-C
cause scurvey and defective collagen synthesis
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Quote:
Originally Posted by miss patho View Post
cause scurvey and defective collagen synthesis
bruises on his legs as well as gingival hemorrhages
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Quote:
Originally Posted by step_enhancer View Post
Ans E. Vitamin D

the patient has rickets .defficiency of vit D presents as bowing of bones, rachitic rosary (beading of ribs) and muscle weakness(floppy baby)

but bruising and gingival haemorrhage is making me confused.
i still go with E.
I think bruising and hemorrhage are not due to vitC def in this case. They indicate thrombocytopenia. Thrombocytopenia with cortisol treatment and vitamin D deficiency could have happened during pregnancy.

Could you post the explanation of the case? Where do you get this Q?
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Old 01-05-2012
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ill go wit vit c def scurvy as wit skeletal presentation pt also shows other c/f
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Quote:
Originally Posted by miss patho View Post
cause scurvey and defective collagen synthesis
advanced scurvy can has scurvritic rosary similar to rickictic rosary.

found this link hope will be helpful.

http://emedicine.medscape.com/article/125350-clinical


nic q scopusmount
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Quote:
Originally Posted by doxorubicin View Post
advanced scurvy can has scurvritic rosary similar to rickictic rosary.

found this link hope will be helpful.

http://emedicine.medscape.com/article/125350-clinical


nic q scopusmount
if the answer is vit C ,its a perfect example how examiners can bring a postgrad topic and eff with us i m sure this not in kaplan, first aid or uworld.

but the bowing legs is classical for Vit D deff also the link you given states if the vit c deff is that advance it will have extensive bleeding into joints also Subperiosteal hemorrhage of distal femur, which is lacking in this pt.

lets see what answer turns out to be
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  #11  
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Quote:
Originally Posted by patho2012 View Post
I think bruising and hemorrhage are not due to vitC def in this case. They indicate thrombocytopenia. Thrombocytopenia with cortisol treatment and vitamin D deficiency could have happened during pregnancy.

Could you post the explanation of the case? Where do you get this Q?
i really dont trust any source (for Qs ) other than uworld and may be kaplan qbank.
coz i did usmlerx like 15 blocks and there were wrong concepts in it.
i think it takes good experienced teachers to make questions.
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Quote:
Originally Posted by doxorubicin View Post
advanced scurvy can has scurvritic rosary similar to rickictic rosary.

found this link hope will be helpful.

http://emedicine.medscape.com/article/125350-clinical


nic q scopusmount
Doxorubicin, could you expl the bowing leg finding? In vitC def, there is only tender bone...
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it is vit D def----Rickets---defective mineralization--bowing of wt bearing bones laterally--Rachitic rosary all these suggest its Vitamin D def.i think the question was supposed to ask which of the vitamin def's cause the above symptoms which would include Vit C def based on gingival bleeding and numerous bruises.
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I will go with Vit C.
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Default just out of curiosity

does a 14m old baby have teeth?
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Vit C def occurs mostly in malnourished ppl like IVDA,homeless and alcoholics.How is earth Vit C def gives Bowed legs?pls explain...
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Default vitD def and Calcium def

Quote:
Originally Posted by step_enhancer View Post
if the answer is vit C ,its a perfect example how examiners can bring a postgrad topic and eff with us i m sure this not in kaplan, first aid or uworld.

but the bowing legs is classical for Vit D deff also the link you given states if the vit c deff is that advance it will have extensive bleeding into joints also Subperiosteal hemorrhage of distal femur, which is lacking in this pt.

lets see what answer turns out to be
I think its vitamin D deficiency, and the cons of that is severe Calcium deficiency that causes coagulation problem. Thats why we see only gum bleeding and bruises.
Bowed legs are also due to Ca deficiency.
Who 's with me?
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Smile A very good Q!!!!

Quote:
Originally Posted by scopusmount View Post
A 14-month-old baby boy is brought to your office by his mother because he seems to be in pain whenever he tries to move. During your physical examination you note bowing of his legs, depression of the sternum with outward projection of the ends of the ribs, reluctance to move his limbs, and numerous bruises on his legs as well as gingival hemorrhages. These findings lead you to suspect that this child suffers from a dietary deficiency of which of the following vitamins?

A. A
B. B1 (thiamine)
C. B12 (cyanocobalamin)
D. C (ascorbate)
E. D (calciferol)
According to the case, the child is brought with the complains of painful limb movements which are indicative of vit C def-subperiosteal hematomas. ( also bruises and haemorrhages). we do see the signs of vit D def but they are not the primary complains of the mother, they are just added physical findings. Hence i feel to this above scenario, vit C def would be a better answer.
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Its Vitamin C , Great question.
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Quote:
Originally Posted by patho2012 View Post
I think its vitamin D deficiency, and the cons of that is severe Calcium deficiency that causes coagulation problem. Thats why we see only gum bleeding and bruises.
Bowed legs are also due to Ca deficiency.
Who 's with me?
hey thats what i thought,hypocalcemia leading to coagulation cascade problems hence bruises and gingival bleeding...
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  #21  
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E: vitamin d
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Old 01-16-2012
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So whats the answer ?????
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Quote:
Originally Posted by anomali View Post
According to the case, the child is brought with the complains of painful limb movements which are indicative of vit C def-subperiosteal hematomas. ( also bruises and haemorrhages). we do see the signs of vit D def but they are not the primary complains of the mother, they are just added physical findings. Hence i feel to this above scenario, vit C def would be a better answer.
good explanation and this is the answer
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The answer should be Vit C: Infantile Scruvy. Kaplan LN 2010 explains it on page 143 with a similar case.
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  #25  
Old 01-16-2012
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vitamin D def
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Quote:
Originally Posted by savleem View Post
vitamin D def
Just a heads up- the answer was Vitamin C.
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Old 01-16-2012
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well the questions asks pt suffer from deficiency of which of the following VitaminS ???? can it be both ?????? vit c and d .... if not then Vit c i guess ..

where is this qs from ?
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