Using the case study and biochemical data, explain your differential diagnosis in this patient and what causes this condition. In your answer,  explain the further tests required to differentiate between different forms of this endocrine condition.

Nandita has been diagnosed with osteomalacia. The results from recent blood tests are given below.

Analyte                                       Patient result                Reference range                 Units

Serum adjusted Ca                               2.0                            2.1 – 2.6                           mmol/L
Serum intact PTH                                 7.5                            1.6 – 6.9                            pmol/L
Serum 25(OH)D                                   15                             >50                                  nmol/L

Using this case study as an example, critically discuss and evaluate the biochemical investigation of vitamin D deficiency. Your answer should include an explanation of why the analytes listed above are measured and an evaluation of the methods used.

A 40-year-old woman went to see her GP because she had gained 12 kg in weight over the last year. Her other symptoms included headaches, generalized weakness, irregular and infrequent menstrual periods and a slight rounding of the face. Her pulse rate was 90 beats per minute and her blood pressure was 160/100 mmHg. Thyroid function tests and a prolactin test, performed in the last few months, showed normal results.

The doctor ordered additional tests and the results are shown below;

Analyte                                Patient result                          Reference Range                         Units
Sodium (Na+)                          140                                           130-145                                    mmol/L
Potassium (K+)                          3.5                                             3.5-5                                       mmol/L
Glucose                                     12                                                <11                                      mmol/L
Creatinine                                125                                           60-120                                     µmol/L
Cortisol                                    1000                                         <200                                        nmol/L

Using the case study and biochemical data, explain your differential diagnosis in this patient and what causes this condition. In your answer,  explain the further tests required to differentiate between different forms of this endocrine condition.

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