Osteomalacia is a condition that can be caused by Vitamin D deficiency. Outline one effect of osteomalacia.

Outline the relationship shown in the graph.

Suggest reasons for this relationship.

Compare and contrast the two ECG traces.

Outline one event that occurs in the heart during the T wave.

softened/weakened bones/bone pain/increased fractures/difficulty walking/stunted growth ✔

a. direct relationship/positive correlation ✔ 

b. increased latitude, higher mortality from falls ✔

Or vice versa

a. higher latitude, lower levels of sunlight ✔

b. less uptake of calcium
OR
less vitamin D ✔

c. higher incidence of osteomalacia leads to higher risk of broken bones/mortality ✔

compare:
a. no difference in the P wave/QRS wave
OR
both traces have all 4 waves/PQRST ✔

contrast:
b. delayed T wave
OR
T wave is shorter/higher in hypocalcemia ✔

Allow reference to events in the cardiac cycle for mpa or mpb

Allow converse statements for mpb.

a. repolarization of ventricles ✔ 

b. ventricles are in diastole/relaxation ✔

Osteomalacia producing weak bones was a common answer. Low calcium levels were also mentioned but this is a cause not an effect of osteomalacia.

Nearly all candidates recognized a positive correlation.

Lack of sunlight leading to less Vitamin D was the most common answer here. Calcium was rarely mentioned.

A difference between the traces was more often seen than a similarity, although many candidates gained the two marks.

Many candidates did not know that ventricular diastole occurs during the T wave.