PAEA Surgery End Of Rotation (EOR) Practice Exam

What metabolic disorder can affect vitamin D metabolism?

1. Chronic kidney disease

2. Hyperthyroidism

3. Primary hyperparathyroidism

4. All of the above

The correct answer is: All of the above

Chronic kidney disease affects vitamin D metabolism primarily through its impact on renal function, which is crucial for the conversion of vitamin D into its active form, calcitriol. In patients with chronic kidney disease, the kidneys' ability to activate vitamin D diminishes, leading to a potential deficiency even if dietary intake is sufficient. This deficiency can contribute to metabolic bone disorders. Hyperthyroidism can also influence vitamin D metabolism. Increased levels of thyroid hormones can lead to accelerated bone turnover and may alter calcium metabolism, impacting vitamin D utilization within the body. As a result, patients with hyperthyroidism may experience heightened levels of vitamin D metabolism demands. Primary hyperparathyroidism results from excess parathyroid hormone, which increases bone resorption and affects calcium and phosphate homeostasis. This excess can alter how vitamin D is metabolized and utilized, leading to potential deficiencies or imbalances in vitamin D levels, exacerbating bone health issues. Thus, all three conditions—chronic kidney disease, hyperthyroidism, and primary hyperparathyroidism—can disrupt the normal metabolism of vitamin D, leading to various metabolic complications. Therefore, the correct answer encompasses all of these metabolic disorders, underscoring their collective role in affecting vitamin D metabolism.