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Old 02-14-2012
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Question NBME form 1 question: Generalized bone pain for 9 years

A 25-year old woman has had generalized bone pain for 9 years. She has frequent episodes of loose bulky stools. Examination shows muscle weakness and a distended abdomen. X-ray shows generalized demineralization of bones, absence of lamina dura, and fracture-like lines in the bones of the feet. What will be the expected effect (increase or decrease) on the following serum lab findings: Calcium, Phosphorus, Alkaline phosphatase, PTH?

please explain your answer.
my answer was incorrect and I dont understand how to derive the correct answer (probably because i'm not quite sure what the pathology here is).
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Old 02-14-2012
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cos she has frequent loose bulky stools---- points to fat malabsorption

so that wud mean VIT D decrease

which wud cause

decrease in Calcium

increase in parathyroid

hence decrease in phosphorous.. cos kidneys are fine...

and increase in ALP
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Old 02-14-2012
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fat malasbsorption! yessss thats the missing link
it all makes sense now

thanks!!
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