Acquired Metabolic Diseases of Bone Flashcards
- Bone needs an intact ______ supply
- Interruption of blood supply: ______, or new bone ______
- ____ _____: Loss of blood to an area of bone
- blood
- necrosis; deposition
- Dry Socket
Bone Healing is Uniqe
-New bone from tissue regeneration will ______ with old bone without forming a _______. Due to cell ______ and _______ synthesis
-Blend; scar; proliferation; collagen
Bone Homeostasis
- _____ _____: 1st and 2nd decades of life while growth is still occurring, important before _____ while the bone is still forming
- _____ _____: Continuous throughout life
- Bone modeling and remodeling during growth establishes skeletal ______ bone _____. As an adult bone _______ maintains _______ and removes ____ bone
- Bone modeling; birth
- Bone remodeling
- Peak; strength; remodeling; strength; damaged
Role of Remodeling Process
- Allows bone to _____
- _______ mobilization, by maintaining ______ & ______ homeostasis
- Mechanical _________ involves the release of more minerals in sites under the most ______
- Blend
- Calcium; calcium & phosphate
- Adaptation; stress
- _______: Resorb bone
- _______: Deposit the bone matrix
- _______: Maintain the quality of the bone
- _______: Cover the surface of the bone
- _________(__): Group of cells collaboratively & sequentially involved in bone _________
- Osteoclasts
- Osteoblasts
- Osteocytes
- Bone lining cells
- Bone Remodeling Unit (BRU); remodeling
-Disorders of bone can be due to: ______, ______, & _____ constituents
-Minerals; proteins; cellular
Dysregulation of Major Function
- _________: Support and muscular attachment
- _________: Protect vital organs and bone marrow (contains bone cells)
- _________: Ion reserve and serum homeostasis
- Mechanical
- Protective
- Metabolic
Disorders of Bone Minerals
- __________
- __________
- __________ Osteodystrophy
- __________ disease
- __________ _______ (Fibrodysplasia Ossificans Progressiva)
- Osteoporosis
- Osteomalacia
- Renal
- Paget’s
- Ectopic Calcifiation
Disorders of Bone Cells
- ______ dysplasia
- Skeletal _______
- Fibrous dysplasia
- Skeletal metastasis
Disorders of Bone Proteins & Enzymes
- __________ Imperfecta
- ___________
- Osteogenesis Imperfecta
- Hypophosphatasia
Drug-Induced Metabolic Bone Disease
-___________ __________ Jaw ________
-Antiresorptive Induced Jaw Osteonecrosis
- _________: Porous bones, aka bones with holes leading to ________ bone strength leading to an increase in _________. Characterized by too little bone ________ or excessive bone _______; possibly both!
- Loss of bone tissue is associated with deterioration in skeletal _________
- Affects __________ people in the US
- __________ can strike at _____ age
- _________: low bone mass not yet converted to osteoporosis, and _________ people in the US are at an increased risk
- Osteoporosis; decreased; fractures; formation; deterioration
- Microarchitecture
- 10 million
- Osteoporosis; any
- Osteopenia; 34 million
Osteoporosis-related Fractures
-________ annually
- At an age ≥ ____: ____% are women and ___% are men
-Hip fractures: __________ annually, where ______ will die within a year
-Annual healthcare cost is ______
Major Challenge is the ______ Population
-By 2020 ______ Americans will be ___ or older
-By 2040 _______ people worldwide will be __ or older
- 1.5 million
- 50; 50%; 25%
- 80,000 men; 1/3rd
- $14 billion
- Aging
- 52 million; 65
- 68 million; 65
Symptoms of Osteoporosis
- ________ bone loss, a ______ disease
- Bone ______ due to low impact trauma
- Collapsed ________ resulting in severe _____ pain; loss of _____, and _______ deformities
- Asymptomatic; silent
- Fractures
- Vertebrae; back; height; spinal
Osteoporosis is a ________ Systemic Disease
- Low bone ___/___
- _________ deterioration of bone tissue/____
- Increased bone ______
- Consequent increase in ________ risks
- ______ & treatable
- Progressive
- mass/quality
- Micro-architectural; quality
- Fragility
- Fracture
- PREVENTABLE
Loss of Bone Strength in Osteoporosis:
- Fewer bone _______ decreases bone ______
- Thin and _________ bone trabeculae
- Increase in _____ infiltration decreasing bone ______
- ALL lead to an increase in bone _______
- Trabeculae; density
- Disjointed
- fatty; quality
- fractures
Mechanisms of Cancellous Bone Loss of Osteoporosis
- Increased activation frequency leading to high bone ______
- Remodeling imbalance resulting in ______ resorption and/or _______ formation
- Dysregulated bone _______
- _______ bone loss due to decreased [Estrogen], resulting in ______ NOT being inhibited
- Turnover
- Increased; decreased
- Remodeling
- Menopausal; Osteoclasts
Age-Related Osteoporosis
- ______ tend to have _____ dense bone formation than _____
- ______ & ______ have an effect on peak bone mass
- ______ are more susceptible to osteoporosis than ____
- Women; less; men
- Age & gender
- Women; men
-______/Vitamin _ deficiency also lead to a decrease in bone ____/_______
-Calcium; Vitamin D; mass/quality
Bone Mass Measurements
- ________ (___): Predictor of osteoporotic fracture risk, and is measured by ______ ____ ______ (___)
- Standard deviation is the ______, a decrease of 1 in bone mass at the ___, ____, or ____ is associated with a ______ of fracture risk
- Women with a BMD < ______ below the mean for a young adult are classified as ________
- Bone Mineral Density (BMD); Dual-Energy X-ray Absorptiometry (DEXA)
- T-Score; spine; hip; wrist; doubling
- (-2.5 SD); Osteoporotic
- Osteoporosis and ______ disease share common etiological factors: ____ & _____
- _______ attachment loss increases with _____
- ______ tend to lose their teeth before ____ due to: ____, ______, & _______
- Periodontal; age & gender
- Tooth; age
- Women; men; age; gender; Osteoporosis
Renal _________
- ______ acts on the kidneys and bones, the kidney will try to conserve ____ and convert _______ to its active form to increase ________ absorption. High [____] inhibits _____ synthesis and stimulation
- _______ damage prevents the formation of active _____ and thus _______ absorption, resulting in an increase in serum ________
- Dysregulated bone _______ and _______ homeostasis
- Osteodystrophy
- PTH; Calcium; Vitamin D; Calcium; [Calcium]; PTH
- Kidney; Vitamin D; Calcium; Phosphate
- Turnover; mineral
-Abnormalities of mineralization of ______ or bone cause Rickets/_______. Along with Vitamin __ deficiency, ______ deficiencies like with decreases in [______] causing hypophosphatasia, and the presence of ______ inhibitors like ________
-Cartilage; Osteomalacia; Vitamin D; Enzyme; ALKPase; mineralization; Aluminum
- _______: Primarily in children before skeletal maturity due to the pre-closure of ______ growth plates, where weight causes the bone to _____ and the legs to ____
- _______: Primarily occurs in adults due to the post-closure of _______ growth plates resulting in easily _______ bones
- _______ can be treated with ________, while ______ cannot and has no cure
- Rickets; epiphyseal; bend; bow
- Osteomalacia; epiphyseal; broken
- Osteomalacia; Vitamin D; Rickets
-_____ ______: Tumor-induced ________
-Oncogenic Osteomalacia; Osteomalacia
Acquired Paraneoplastic Synddrome
-Disorder of bone _____
-______ is common
-Vitamin ___ resistant _______
- Induced by a bone/soft tissue ______
-Metabolic abnormality _______ reversed with ______ removal
Pathophysiology:
-Tumor impedes Vitamin D ______ where ______Vitamin D is converted to _____ Vitamin D
-______ ______ wasting
-Poor bone _____, causing ____, and ______
- Mineral
- Osteopenia
- Vitamin D; Osteomalacia
- Tumor
- Completely; tumor
- Metabolism; inactive; active
- Renal phosphate
- Mineralization; pain; fractures
-______ ______(_____): Secretes Phosphatonin (_____) that targets the ______ renal tubes of the _____. This leads to Phosphate ______ and abnormal _______ metabolism. In the blood there is low ____ levels of ______ and ______ as a result. Will result in _______
-Mesenchymal Tumor (PMTMCT); (FGF23); proximal; kidneys; wasting; Vitamin D; serum; phosphorus; Vitamin D; Osteomalacia
Bone Histology
-_________ bone appears black, while the surrounding blue is Osteoid that hasn’t been ________
-Mineralized; mineralized
Skeletal Cancer Metastasis
- Abnormal bone _______
- Bone _______ appears radio-________ and _____
- Bone ________ appears radio-______ and ______
- Seen in both _______ & ________ cancers
- Metabolism
- breakdown; radiolucent; lytic
- deposition; radiopaque; sclerotic
- Breast & Prostate
