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RAHITISMUL CARENTIAL

CURS STUDENTI 2011

DEFINITIA RAHITISMULUI
-boala afectand in p incipal !c"elet#l in pe ioada de c e!te e$la ad#lt%o!teo&alacia' -ca acte i(ata p in in&#ie ea oa!elo -)defo &a i !c"eletice !i f act# i*pe o! patolo+ic* -dete &inata de ca enta de ,ita&ina D-alte a ea &etaboli!&#l#i ace!teia !a# ca enta-afecta ea &etaboli!&#l#i Ca-.

META/0LISMUL 1ITAMINEI D$1'


-S# !a endo+ena2cole!te ol#l din piele !#b acti#nea #,--)CC -S# !a e3o+ena2,ita&ina D de o i+ine ,e+etala$fito!te ol' !a# din ali&ente de o i+ine ani&ala$CC'

SURSE NUTRITI0NALE DE 1ITAMINA D


-laptele &ate n$410 #i-L' -laptele de ,aca$ap o3510 #i-L' -#nt#l -+alben#!#l de o# -#lei#l de ficat de pe!te -ca nea #no pe!ti -&a +a ina -p epa atele de lapte pt5!#+a ice ealele i&bo+atite in ,it5D

META/0LISMUL 1ITAMINEI D$2'


-Ab!o btia2la ni,el#l ileon#l#i5nece!ita e&#l!iona ea in p e(enta bilei -T an!fo &a ea in &etabolit acti,2 -26-"id o3ila ea "epatica$26-0H-CC' -1 alfa "id o3ila ea enala$1726-di"id o3i CC'%META/0LITUL ACTI18 -Depo(ita ea2ficat7&#!c"i7+ a!i&e5DE.0 9ITE INSUFICIENTE8

META/0LISMUL 1ITAMINEI D$:'


Sediile !i tip#l acti#nii$1'2 -Inte!tin-fa,o i(ea(a ab!o btia Ca$!i a .' -0!-fa,o i(ea(a elibe a ea Ca din o!$p in inte &edi#l .TH--)no &ali(a ea calce&iei' -fa,o i(ea(a dep#ne ea Ca la ni,el#l (onei p epa ato ii de calcifica e a o!#l#i$p od#! Ca3.' -fa,o i(ea(a o!ifica ea encond ala -&entine inte+ itatea !t #ct# ii o!#l#i -a!i+# a c e!te ea in l#n+i&e a o!#l#i

META/0LISMUL 1ITAMINEI D$;'


Sediile !i tip#l acti#nii$2'2 -Rinic"i#l-fa,o i(ea(a eab!o btia t#b#la a a fo!fatilo -SN.-cont olea(a e3citabilitate ne# o&#!c#la a -M#!c"i#l !c"eletic-cont olea(a ton#!#l !i fo ta &#!c#la a !i altele

RAHITISMUL-MANIFESTARI CLINICE$1'
-d# e i o!oa!e7!en!ibilitate la p e!i#ne -c aniotabe!7&ac ocefalie7*bo!e*f ontale !i pa ietale -defo &a i o!oa!e2 -inc# ba ea MI -cifo(a a"itica -MS2*b ata i* a"itice -!ant Ha i!on -defo &a i pel,ine

RAHITISMUL-MANIFESTARI CLINICE$2'

-pe t# ba ea c e!te ii in l#n+i&e a oa!elo $<nani!&#l a"itic*' -t#&efie ea a tic#latiilo cond oco!tale$<nani!&#l a"itic*' -tendinta c e!c#ta la f act# i7f act# i*in le&n ,e de -"ipotonie &#!c#la a -"ipe e3citabilitate ne# o-&#!c#la a 7tetanie a"itica

RAHITISMUL-MANIFESTARI CLINICE$:'
-!cade ea e(i!tentei la infectii7infectii e!pi ato ii7otice 7di+e!ti,e f ec,ente7c# e,ol#tie p el#n+ita -&anife!ta i denta e2inta (ie ea e #ptiei7di!t ofie denta a Si altele555

RAHITISMUL-SEMNE /I0L0=ICE

-"ipocalce&ie-"ipofo!fate&ie -FAS c e!c#te -ni,el#l !e ic al 26 0H CC !i 1726 $0H'2 CC !ca(#t

E.IDEMI0L0=IA RAHITISMULUI CARENTIAL


RISC CRESCUT DE RAHITISM2 -1a !ta$:-2; l#ni' -S#+a i ali&entati nat# al7&a&e e3p#!e in!#ficient la !oa e -S#+a i e3p#!i in!#ficient la !oa e -S#+a i ali&entati a tificial-di,e !ificati inco ect -Dia ee c onica7con!#& in!#ficient de lapte !i p od#!e lactate

CLASIFICAREA ETI0L0=ICA A RAHITISMEL0R


-Ra"iti!&#l ca ential$<co&#n*' -Ra"iti!&ele ,it5D e(i!tente -Deficite en(i&atice con+enitale -/oli "epatice c onice -Sind oa&e de &alab!o btie -T ata&ente anticon,#l!i,ante -1it5D dependenta

-Utili(a ea p epa atelo de lapte-ce ealelo -ali&entelo pt5!#+a i i&bo+atite in ,it5D -Ad&ini!t a e !#pli&enta a de ,it5D 600 #i-(i7(ilnic72 !apt5--)1 an .R0/LEME2 -do(e &ai &a i la p e&at# i7copii c# i!c c e!c#t? -p el#n+i ea ad&ini!t a ii in !e(on#l ece pana la : an?7pana la adole!centa?

.R0FILA>IA RAHITISMULUI CARENTIAL$1'

.R0FILA>IA RAHITISMULUI CARENTIAL$2'

-E3p#ne ea la !oa e7 #, -Ad&ini!t a ea !#pli&enta a de Ca :0-60 &+@+c-(i7daca n# con!#&a cel p#tin 600 &l lapte-(i !a# ec"i,alent#l in p od#!e lactate

TATAMENTUL RAHITISMULUI CARENTIAL


-Ad&ini!t a ea te pe#tica de ,it5D -D09A NECESARA 1INDECARII% 200 000-A00 000 #i -6-10 000#i-(i7pe o!7A-B !apt -200 000 #i i&32-: ad&ini!t a i7 S#b cont ol#l calce&iei8 -Ad&ini!t a e !#pli&enta a de Ca

T0>ICITATEA 1ITAMINEI D

-Hipe ten!i#ne int ac aniana$,a !at# i7bo&ba ea fontanelei7con,#l!ii7co&a' -Hipe calce&ie--)dep#ne e de calci# in te!#t# i$Nef ocalcino(a88' -In!#ficienta enala ac#ta