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Question 1

How might you increase heart contractility?

Answer 1

Sympathetic activation

+ ionotropic drugs

Question 2

From what at osteoclasts derived?

Answer 2

Macs; osteocytes = giant cells!

Question 3

Osteoblasts:
Describe their life cycle
How do they communicate?

Answer 3

Osteoblasts –> become CYTES and live in lacunae

Communicate via the canaliculi

Question 4

Basic pathogenesis of osteoporosis + causes/risks

Answer 4

Osteoclasts&raquo_space;> osteoblasts

• menopause (low estrogen)
• steroid use
• loop diuretics
• low vitamin D/Ca intake
• alcohol/ smoking/lack of exercise

*** but not necessarily obesity. Low weight women are actually at higher risk. So you can basically either have diabetes or osteoporosis when you get old. Your choice. But you cannot win. 😂)

Question 5

Where is the femoral vein in relationship to the artery.

Answer 5

NAVL.
All of first year, I told myself: L means Lick the Penis. The penis is medial. L is medial. So NAVL goes Lat –> Med.

The femoral vein is MEDIAL to the femoral artery.

Question 6

Three more common treatments for osteoporosis

Answer 6

• vitamin D/Ca supplements
• bisphosphonates to inhibits clasts (–“dronates”)
• Teriparatide (recombinant PTH) but only for up to two years

Question 7

Two strange ADRs of bisphosphonates

Answer 7

• Errosive esophagus

- necrosis of the jaw; esp after procedures

Question 8

Why ISNT estrogen used to treat osteoporosis?

Answer 8

Because it increases risk of MI/CVA

Question 9

Other than bisphosphonates, what is a less commonly used osteoclast inhibitor?

Answer 9

Denosumab

“OSTEOCLASTS! YOU BREAKIN MY BONES? Ok, DEN. You gonna get jumped by the MOB. (Mab))!!! And not even RANKL will save you!!”

Blocks RANKL

Question 10

What is deficient in osteoPETROSIS?
What are some classic findings?
Labs?

Answer 10

Carbonic anhydrase 2 in osteoCLASTS

• erlenmyer flask deformity
• CN entrapment
• pancytopenia (cause the marrow area is smashed up full of bone)
• failure normal labs
• essentially normal labs

Question 11

Pagets:
Pathogenesis
Some classic findings
Labs?

Answer 11

Osteoclasts go crazy breaking things; then blasts come in and fix the fractures all strange. Get LOTS of DISORDERED bone production.

• grass blade fracture
• “increased hat size” (skull size)
• hearing trouble (narrowed auditory foramina

Labs are relatively normal

Question 12

Osteomalacia- same as?
Classic findings?
Labs?

Answer 12

Ricketts; vitamin D deficiency –> Ca deficiency

• get BOWED LEGS; “soft poorly mineralized bones”
• low Ca –> high PTH –> low phosphate

Question 13

Polyostotic dysplasia:
May be part of what disease?
Pathogenesis?

Answer 13

Bone replaced by collagen and fibroblasts to get irregular trabeculae

May be part of McCune Albright

Question 14

Three McCune Albright findings

Answer 14

Precious puberty, cafe au lait, fibrous dysplasia

Question 15

Von RECKLINGHAUSEN!!!

• other less cool name
• pathogenesis
• findings

Answer 15

Osteitis fibrosa cystica
Endocrine disorder: HYPERparathyroid; pseudohypoparathyroid
Causes ^^ PTH; = bone breakdown.
Get: “brown tumors” & low bone density

Question 16

What is pseudohypoparathyroid?

Answer 16

Renal tubule resistance to PTH; body pumps out MORE PTH as a result

Question 17

Lab findings assc with osteitis fibrosa cystica?

Answer 17

^PTH and Ca; decreased phosphate

Question 18

Bone enlargement, pain and arthritis are assc with?

Answer 18

Lecture says Pagets; don’t know why this couldn’t also be osteopetrosis

Question 19

Vertebral compression fractures should make you think of?

Answer 19

Osteoporosis