DrVirgo
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I think its A...
Malabsorption causes decreased Calcium, so Increased PTH, and therefore decreased Po4.. But what about Alk phos? WHY is it INCREASED?
Also what disease/condition does this woman have? (some type of fat malabsorption problem I think)
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| robin082006
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C
steatorhea-->vit D deficiency---> decreased Ca++ and increased phosphate---> increased PTH--> increased alkaline phosphate.
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| DrVirgo
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When Vit D decreases, PO4 should also decrease because normally vitamin D is repsonsible for intestinal and bone reab. of PO4!!
-What is the cause of steatorrhea in this patient? Malabsorption? Do we know the exact cause?
-Also can you explain WHY Alk. Phos is increased? (is it because it is relaeased from the bones?)
Thanks. 
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| Flying h4x0r
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also an increase in pth will decrease phosphorous
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| robin082006
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PTH stimulates both osteoblasts and osteoclasts---> increase ALk. Phos
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| rm
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A...
the ca is low (b/c of lose fatty stools) so phosphate is low, causing pth to be high and since there are bone fractures alk phos will be high
correct me if im wrong
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| nadiabarati
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A
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| study_ing
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answer is a but rm i d like to point out that usually ca and phosphate move in the opp direction ( becuse of the solublity product) ...in this case the vit d deficiencyand the secondary hyperpth is the cause of low phosphate.
in osteomalacia btw pseudofractures are also described. these are probably due to pulsating arteries and are perpendicular to the bone surface.
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| drpkaur
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A
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| aim
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LOOKING AT PHOSHATE C -----IS CORRECT ANS
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| fox
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A
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| sataleees
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it is A..
in steatorrhea secondary to any cause (eg.obstructive jaundice or intestinal disease) there is decrease in absorbtion of lipid soluble vitamins and vitamin D is one of them (KEDA) ..
so decrease in absorbtion of both Ca and phosphate from the intestine,decreased reabsorbtion of Ca in the kidney and less mobilization from bone through vitamin D..
the body will TRY to compensate for that by increase PTH which will incease bone resorptin through osteoplast ana osteoclast reflected in increase the enzyme alkalaini phosphatase and slight incomlete correction of calcium and more impotant increase phosphate execretion..
so.. low Ca, low phosphate, high PTH, and high alkaline phosphatase..
good luck all
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