Endocrinology

Answer 5 Vitamin D deficiency. As the elderly population increases, vitamin D deficiency is becoming more and more common and is usually related to poor nutrition combined with limited exposure to sunlight; the 2 sources of vitamin D are the diet and cutaneous synthesis after ultraviolet irradiation. Although the patient’s back pain could be explained by any of the suggested diagnoses, osteoporosis is not usually accompanied by calcium abnormalities. Multiple myeloma and primary hyperparathyroidism more frequently present with hypercalcemia; renal failure should have manifested other signs, apart from the hypocalcemia. Click here to return to the questions

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