Acquired Diseases of Bone

Question 1

Primary osteoporosis

Answer 1

Typically postmenopausal, following andropause, age-related in men and women (more prevalent in women), low bone mass (low BMD), microarchitecture disruption, fracture with minimal trauma, tends to be in trabecular bone

Question 2

Secondary osteoporosis

Answer 2

Quantitative and qualitative changes in bone structure as the result of disease (such as hyperparathyroidism), medications (excess use of glucocorticoids), deficiencies (vitamin D deficiency), or other (alcoholism, tobacco use)

Question 3

Phases in the development of Paget’s disease

Answer 3

Osteoclastic (lytic), mixed osteoclastic-osteoblastic, osteoblastic

Question 4

Osteomalacia

Answer 4

Deficient mineralization of bone and cartilage that occurs after the epiphyseal plates have closed in adults and is due to many secondary causes such as vitamin D deficiency or tumor induced

Question 5

Rickets

Answer 5

Deficient mineralization of bone and cartilage that occurs in growing bones of children. It can be caused by deficiencies, insensitivity to or derangement of metabolism of vitamin D, calcium or phosphorus. Can result in profusion of disorganized, nonmineralized, degenerating cartilage, widening of the epiphyseal plate, rachitic rosary, swelling at the ends of long bones, growth retardation

Question 6

Hyperparathyroidism changes

Answer 6

Hypercalcemia, elevated bone turnover, subperiosteal resorption of cortical bone in phalanges, salt and pepper appearance of skull, bone cysts, osteoporosis

Question 7

Biochemical markers of bone formation

Answer 7

Type I collagen propeptides (P1NP in serum), bone specific alkaline phosphatase (bAP in serum), osteocalcin (in serum)

Question 8

Biochemical markers of bone resorption

Answer 8

Type I collagen telopeptides (NTx or CTx in serum or urine), pyridinoline/hydroxypyridinoline (in urine)

Question 9

Antiresorptive agents

Answer 9

Bisphosphate, denosumab, nasal calcitonin, sclerostin inhibitors

Question 10

Bone-forming agents

Answer 10

Parathyroid hormone