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Vitamin D deficiency osteomalacia — SCE Endocrinology MCQ

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HardCalcium/BoneVitamin D deficiency osteomalaciaSCE Endocrinology

A woman has symptomatic osteomalacia with 25-OH vitamin D 9 nmol/L, hypophosphataemia and secondary hyperparathyroidism. She has no malabsorption. Which replacement regimen is suitable?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Colecalciferol loading totalling 300000 IU followed by daily maintenance

Explanation lettering: D = shown as C · E = shown as D · C = shown as E

A is correct. Symptomatic severe deficiency can be loaded with a total of about 300,000 IU colecalciferol over 6–10 weeks, followed by maintenance commonly 800–2,000 IU daily, while ensuring calcium intake and checking response. Activated vitamin D is reserved for selected renal/metabolic indications and needs monitoring. Tiny one-off dosing, bisphosphonate before correction and phosphate alone do not treat osteomalacia.

Reference: https://cks.nice.org.uk/topics/vitamin-d-deficiency-in-adults-treatment-prevention/