Osteoporosis - MSK - Medbullets Step 1

Snapshot
- A 68-year-old woman presents to her primary care physician with lower back pain of acute onset. She denies any trauma to the spine or any radiation of pain. Her last menstrual period was when she was 51-years-old. On physical exam, she has tenderness to palpation at the level of L4-L5, as well as a loss of lumbar lordosis. A dual-energy x-ray absorptiometry (DEXA) scan reveals a T-score of -2.7.

Differential

Laboratory Abnormalities in Select Bone Disorders
Etiology	Serum Phosphate	Serum Calcium	Serum Alkaline Phosphatase	Parathyroid Hormone
Osteomalacia / rickets	Decreased	Decreased	Increased	Increased
Osteoporosis	Normal	Normal	Normal	Normal
Osteopetrosis	Normal	Normal or decreased	Normal	Normal
Paget disease of the bone	Normal	Normal	Increased	Normal
Osteitis fibrosa cystica	Primaryhyperparathyroidism decreased Secondaryhyperparathyroidism increased	Primaryhyperparathyroidism increased Secondaryhyperparathyroidism decreased	Primary and secondary hyperparathyroidism increased	Primary and secondary hyperparathyroidism increased
Hypervitaminosis D	Increased	Increased	Normal	Decreased

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