Biochemistry Flashcards
name the quantitative defect of bone characterised by reduced bone mineral density and increased porosity (i.e. the bone is of normal quality, there is just not enough of it)
osteoporosis
what is there increased risk of in osteoporosis?
increased fracture risk
WHO defines osteoporosis when the bone density is ___ SD away from the mean
WHO defines osteoporosis when the bone density is 2.5 SD away from the mean
loss of bone density occurs at what age?
30 - gradual slowdown of osteoblasts
who tends to lose more bone density and after what especially?
females - post menopause
increased osteoclastic activity as loss of oestrogen protective effects
how many types of osteoporosis are there? name them
2
type 1 - post-menopausal
type 2 - osteoporosis of old age
risk factors of osteoporosis (post menopausal))?
smoking
alcohol
lack of exercise
poor diet
what type of fractures are seen in osteoporosis?
colles fractures and vertebral insufficiency
risk factors for osteoporosis of old age?
chronic disease
inactivity
reduced sunlight exposure
smoking
alcohol
lack of exercise
poor diet
CKD malignancy RA cushing's hyperthyroidism hyperparathyroidism
the above all cause what?
osteoporosis
how do you diagnose osteoporosis?
DEXA bone mineral density scan
how do you rebuild bone density in osteoporosis?
exercise
diet
sunlight
pharmaceutical treatments of osteoporosis?
calcium and vitamin D supplements
biphosphonates (-ate)
desunomab
strontium
zoledronic acid is a once yearly IV bisphosphonate
___ is not recommended as a first line agent for the prevention of osteoporosis after the menopause however can be considered if side effects with other medications occur
HRT is not recommended as a first line agent for the prevention of osteoporosis after the menopause however can be considered if side effects with other medications occur
what has the greatest evidence for efficacy, cost‐effectiveness and low side effect profile?
bisphosphonates
a qualitative defect of bone with abnormal softening of the bone due to deficient mineralization of osteoid (immature bone) secondary to inadequate amounts of calcium and phosphorus
name the above disease
osteomalacia
what is the same disease as osteomalacia but occurs in children which has subsequent effects on the growing skeleton
Rickett’s
what causes osteomalacia and Rickett’s?
insufficient calcium
vitamin D deficiency
phosphonate deficiency
malnutrition malabsorption lack of sunlight hypophosphateamia in re-feeding syndrome alcohol abuse long term anticonvulsant use and chronic kidney disease
is osteomalacia and Rickett’s painful?
yes
osteomalacia and Rickett’s clinical signs and symptoms?
deformities in Rickett’s
pathological fracture
hypocalcaemia symptoms such as fatigue seizures and brittle nails
osteomalacia and Rickett’s on radiographs?
pseudo fractures - Looser’s zones
bone biochemistry of osteomalacia and Rickett’s:
calcium
phosphatase
alkaline phosphatase
LOW calcium
LOW phosphatase
HIGH alkaline phosphatase
osteomalacia and Rickett’s treatment?
vitamin D therapy
calcium and phosphate supplementation
in hyperparathyroidism, there is high levels of what?
high PTH
