What this deck covers
Calcium, Vitamin D and Rickets in 18 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.
Board-style teaching questions for paediatricians and trainees preparing for board, MRCPCH and Prometric examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.
The 18 cases, in order
- Jittery on day two
- A seizure at the end of week one
- Fitting and not stopping
- A heart murmur and a small chin
- Who needs the drops
- What the wrist film shows
- The hormone that ties it together
- How long, and what next
- Bowed legs, normal vitamin level
- Treatment given, no improvement
- A number that is too small
- Tingling six weeks later
- The signal that goes unheard
- A high calcium and a friendly baby
- Six weeks flat on his back
- Stones, bones and a low mood
- One very high number, well child
- Calcium given, calcium falls again
Diagnoses and management options tested
Across the 18 cases you are asked to choose between options such as: A parathyroid gland that has failed permanently, A high phosphate load from the feed, A phenytoin loading dose before anything else, An exaggerated early dip after a difficult birth, Only the exclusively breastfed infants, Dense sclerotic bone throughout the whole skeleton, Raised, driven by the low calcium, A single injection with no further treatment, Nutritional vitamin D deficiency rickets, A disorder of phosphate handling by the kidney, The loss of teeth, The parathyroid glands were damaged at operation, The glands have been removed at surgery, Primary overactivity of the parathyroid glands.
Clinical pearls from this deck
- Check the magnesium. Calcium given to a magnesium-deficient baby simply falls again.
- Early dips resolve on their own. Late hypocalcaemia always has a cause you have to find.
- Slowly, and watch the monitor. Fast intravenous calcium has stopped hearts.
- Look for the thymus on the chest film. It is free, and it makes the diagnosis.
- A sunny country is no protection if the skin is covered or the child is under a year old.
- The signs appear where growth is fastest, which is why the site changes with the child’s age.
Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.
More from this system: all Endocrinology Board Questions case decks · pediatric reference values.
