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Medicine Endocrinology 5b457a2e

Which of the following is seen in Vitamin D deficiency-

A
Increased alkaline phosphatase
B
Decreased phosphate in urine
C
Hyperphosphatemia
D
Decreased alkaline phosphatase
High-Yield Explanation
Vitamin D deficiency leads to impaired intestinal absorption of calcium, resulting in decreased serum total and ionized calcium values. This hypocalcemia results in secondary hyperparathyroidism, a homeostatic response that initially maintains serum calcium levels at the expense of the skeleton. Due to the PTH-induced increase in bone turnover, alkaline phosphatase levels are often increased. In addition to increasing bone resorption, PTH decreases urinary calcium excretion while promoting phosphaturia. This results in hypophosphatemia, which exacerbates the mineralization defect in the skeleton. Reference : page 2466 Harrison's Principles of Internal Medicine 19th edition

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