The following groups should be advised to take vitamin D supplementation:
all pregnant and breastfeeding women should take a daily supplement containing 10µg
of vitamin D
all children aged 6 months - 5 years. Babies fed with formula milk do not need to take
a supplement if they are taking more than 500ml of milk a day, as formula milk is
fortified with vitamin D
adults > 65 years
'people who are not exposed to much sun should also take a daily supplement'
Testing for vitamin D deficiency
The key message is that not many people warrant a vitamin D test. The NOS guidelines
specify that testing may be appropriate in the following situtations:
patients with bone diseases that may be improved with vitamin D treatment e.g.
known osteomalacia or Paget's disease
patients with bone diseases, prior to specific treatment where correcting vitamin
deficiency is appropriate e,g, prior to intravenous zolendronate or denosumab
patients with musculoskeletal symptoms that could be attributed to vitamin D
deficiency e.g. bone pain ?osteomalacia
Patients with osteoporosis should always be given calcium/vitamin D supplements so testing
is not considered necessary. People who are at higher risk of vitamin D deficiency (see above)
should be treated anyway so again testing is not necessary.
External Link
Chief Medical Officer
2016 Vitamin D guidance
NICE
2014 Vitamin D recommendations
,Question 1 of 134
Reactive arthritis is associated with which one of the following HLA antigens?
HLA-B27
HLA-A3
HLA-DR4
HLA-B5
HLA-DR3
,Question 1 of 134
Reactive arthritis is associated with which one of the following HLA antigens?
HLA-B27
HLA-A3
HLA-DR4
HLA-B5
HLA-DR3
Discuss and give feedback
Reactive arthritis
, Question 2 of 134
A 47-year-old man with a history of chronic sinusitis presents with shortness of breath to the
Emergency Department. Initial investigations reveal:
Hb 10.4g/dl
Platelets 477 * 109/l
WCC 14.3 * 109/l
ESR 92 mm/h
Urea 20 mmol/l
Creatinine 198 µmol/l
Urine dipstick blood +++
What is the most likely diagnosis?
Mixed cryoglobulinaemia
Churg-Strauss syndrome
Granulomatosis with polyangiitis
Haemolytic uraemic syndrome
Henoch-Schonlein purpura
all pregnant and breastfeeding women should take a daily supplement containing 10µg
of vitamin D
all children aged 6 months - 5 years. Babies fed with formula milk do not need to take
a supplement if they are taking more than 500ml of milk a day, as formula milk is
fortified with vitamin D
adults > 65 years
'people who are not exposed to much sun should also take a daily supplement'
Testing for vitamin D deficiency
The key message is that not many people warrant a vitamin D test. The NOS guidelines
specify that testing may be appropriate in the following situtations:
patients with bone diseases that may be improved with vitamin D treatment e.g.
known osteomalacia or Paget's disease
patients with bone diseases, prior to specific treatment where correcting vitamin
deficiency is appropriate e,g, prior to intravenous zolendronate or denosumab
patients with musculoskeletal symptoms that could be attributed to vitamin D
deficiency e.g. bone pain ?osteomalacia
Patients with osteoporosis should always be given calcium/vitamin D supplements so testing
is not considered necessary. People who are at higher risk of vitamin D deficiency (see above)
should be treated anyway so again testing is not necessary.
External Link
Chief Medical Officer
2016 Vitamin D guidance
NICE
2014 Vitamin D recommendations
,Question 1 of 134
Reactive arthritis is associated with which one of the following HLA antigens?
HLA-B27
HLA-A3
HLA-DR4
HLA-B5
HLA-DR3
,Question 1 of 134
Reactive arthritis is associated with which one of the following HLA antigens?
HLA-B27
HLA-A3
HLA-DR4
HLA-B5
HLA-DR3
Discuss and give feedback
Reactive arthritis
, Question 2 of 134
A 47-year-old man with a history of chronic sinusitis presents with shortness of breath to the
Emergency Department. Initial investigations reveal:
Hb 10.4g/dl
Platelets 477 * 109/l
WCC 14.3 * 109/l
ESR 92 mm/h
Urea 20 mmol/l
Creatinine 198 µmol/l
Urine dipstick blood +++
What is the most likely diagnosis?
Mixed cryoglobulinaemia
Churg-Strauss syndrome
Granulomatosis with polyangiitis
Haemolytic uraemic syndrome
Henoch-Schonlein purpura
