Phys Clinical Cases · endocrine
Metabolic Bone Disease AND Vitamin D Disorders — DCE Clinical Case
DCE long-case and short-case station for Metabolic Bone Disease AND Vitamin D Disorders.
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Metabolic Bone Disease AND Vitamin D Disorders — Clinical Case
DCE Long Case
Patient brief
Patient: A middle-aged or older adult with multimorbidity and a presentation centred on Metabolic Bone Disease AND Vitamin D Disorders. [1]
Presenting complaint: Subacute or acute symptoms referable to Metabolic Bone Disease AND Vitamin D Disorders, with enough detail to force prioritisation. [1] [2]
Past history: Common cardiometabolic and organ comorbidities that interact with the plan. [2]
Medications: A polypharmacy list that includes at least one interaction or dosing issue. [2]
Examination: Key positives and critical negatives for dangerous differentials. [1]
Investigations: A small set of results that change management. [1] [2]
Tasks
- Present a prioritised problem list. [1]
- Defend investigations and immediate therapy. [1] [2]
- Provide safety-net and follow-up advice. [2]
Model discussion points
- Working diagnosis and acuity. [1]
- Differentials and discriminators. [2]
- Treatment sequence and monitoring. [1] [2] [3]
- Multimorbidity and communication. [2]
You have read the opening of this clinical case. The complete unit — every section and its primary-source references — is part of the Physician Medicine fellowship atlas.
References8Show ledgerHide ledger
- [1]Amouroux C, Porquet-Bordes V, Adler E, Goff YL, et al. French national diagnosis and care protocol (PNDS) for infantile idiopathic hypercalcemia (IIH) Orphanet J Rare Dis, 2026.PMID 42469912
- [2]Zhuang J, Su D, Gao Q, Hu L, et al. Evaluating combined acupuncture and antiresorptive therapy in Chinese women with postmenopausal osteoporosis: a systematic review and network meta-analysis Front Endocrinol (Lausanne), 2026.PMID 42460309
- [3]Yang R, Zeng H, Xiao Q, Xie Y, et al. Endocrine‑metabolic imbalance drives osteoarthritis: From whole‑joint pathobiology to precision therapy (Review) Int J Mol Med, 2026.PMID 42429052
- [4]Premikha M, Ricci V, Kan SJ, et al. Translating evidence into primary care: Singapore's 2025 national osteoporosis guideline and a multilevel framework for assessing guideline impact in mixed health systems Fam Med Community Health, 2026.PMID 42399071
- [5]Sidbury R, Alikhan A, Bercovitch L, Cohen DE, et al. Guidelines of care for the primary prevention of atopic dermatitis and awareness of comorbid conditions in pediatric atopic dermatitis J Am Acad Dermatol, 2026.PMID 41949509
- [6]Sosa-Henríquez M, Torregrosa-Suau Ó, Gómez de Tejada-Romero MJ, Cancelo-Hidalgo MJ, et al. Rethinking Vitamin D Deficiency: Controversies and Practical Guidance for Clinical Management Nutrients, 2025.PMID 41305623
- [7]Xi Y, Yao T, Zhang C, Zhuang T Effectiveness of safety care and clinical nursing pathway in patients undergoing cardiovascular intervention: a randomized controlled trial Perioper Med (Lond), 2026.PMID 42469924
- [8]Marks FJ, Walters SJ, Sutton L, Jacques RM What statistical methods are more appropriate for predicting recruitment at the design stage of a randomised controlled trial? Trials, 2026.PMID 42469922