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ENDOCRINE > Bone > Flashcards

Bone Flashcards

1
Q

HORIZON

A

Zolendronic acid

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2
Q

FREEDOM trisl

A

Denosumab

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3
Q

Teriparatide

A

Recombinant parathyroid hormone analogue

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4
Q

Animal source of Vit D

A

D3 choleclciferol

D2- ergocalciferol plant

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5
Q

Half life of PTH

A

2 mins

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6
Q

Effect of PO4 on PTH

A

Increased

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7
Q

If you have high PTH levels, why do you have high urine calcium

A

Highinitial filtered load even if PTH serves to increase absorption of calcium

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8
Q

Site of action of PTH in the kidneys

A

Distal tubules (only 10%)

20% cTAL
The majority in PCT

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9
Q

Potent activator of PTH2R

A

TIP39

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10
Q

PTH receptor which can be activates by PTH but not by PTHrP

A

PTH2 receptor

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11
Q

Blocks binding of RANKL to RANK (osteoclasts)

A

OSeoprotegerin

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12
Q

Can not increase urinary cAMP levels in response to PTH show clear renal resistance to PTH

A

Pseudohypoparathyroidism type I

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13
Q

Induces 1a hydroxylation of Vit D

A

PTH

Hypophosphatemia

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14
Q

Represses 1a hydroxylation of Vit D

A

Calcium
1,25 OH2 D
FGF23

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15
Q

Half life of 1,25 dihydrocy vitD

A

6-8 hrs

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16
Q

Effect of hypomagmesemia on calcium

A

Hypo Mg inhibits PTH hence calcium release hence hypocalcemia

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17
Q

Defect in FHH

A

Casr mutation inactivating

Increased ca absorption

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18
Q

Decreased urinary cAMP response to PTH

Decreased PO4 response to PTH

A

Pseudohypoparathyroidism 1

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19
Q

Pseudohypoparathyroidism 1 aspsxiated with other hormonal resistance

A

Pseudohypoparathyroidism 1a

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20
Q

Normal urinary cAMP response to PTH

Decreases PO4 response to PTH

A

Pseduohypoparathyroidism 2

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21
Q

Pseudohypoparathyroidism
GNAS1 locus imprinting abnormLity
Not accompanied by any of the clinical features of AHO

A

Pseudohypoparathyroidism 1b

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22
Q

Recommended dietary allowance for vitamin D

A

200 IU

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23
Q

Recommended dietary allowance for vitamin D in the absence of solar exposure

A

400-600 IU

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24
Q

How to differentatiate hypocalcemia of vit D deficiency versus hypoparathyroidism

A

Vit D def has
Phosphatiuria
Pypophosphatemia

25
Q

Short stature
Round face
foreshortened 4th and other metacarpals
Subcutaneous calcifications

A

Albright hereditary osteodystrophy

26
Q

Vitamin D sufficiency

A

> 50 nmol /L (20 ng/mL)

27
Q

Rule out fat malabsorption in patients with these levels of vitamin D

A

<8 ng/dL

28
Q

Effect of anti TB drugs to vitamin D

A

Increased metabolism

29
Q

When does impaired 1a hydroxylation of Vit D take place

A

eGFR 30-40/ min

30
Q

EGFR reduce bisphosphonates

A

< 30 ml/min

31
Q

Bisphosphonate with First dose hypersensitivity

A

Ibandronic acid

32
Q

Recommended sose or calcitonin

A

Nasal 200 IU/day

Subcutaneous 100 IU/ day

33
Q

Trial after 6 yrs BMD continued to improce and fracture risk remained low with denosumab

A

FREEDOM

34
Q

Proteinase that is secreted by osteoclasts and results in bone degradation

A

Cathepsin k

35
Q

Cathepsin K inhibitor

A

Odanacatib

36
Q

Improves BMD in spine and hip

A

Denosumab

37
Q

Why was strontium not approved by FDA

A

Cardiovascular events

38
Q

AEs include
Atypical femus fracture
Osteonecrosis of the jaw

A

Bisphosphonates

39
Q

Anabolic agents

A

PTH
Teriparatide
Monoclonal ab to sclerostin

40
Q

Produced by osteocytea and inhibits bone formatuon by blocking Wnt signaling

A

Sclerostin

41
Q

When is peak bone mass acquir d

A

Age 10-16

Boys peak 2 yrs later than girls

42
Q

Limut when to take teriparatide

And why

A

2 yrs

Osteosarcoma in mice

43
Q

Mechanism osteoporosis of Gc

A

Ucoupling in bone remodeling unit
Inhibition of calcium absorption in gut
Stimulation of osteoclastogenesis

44
Q

Prevention pf glucocorticoid induced osteoporosis

A

Bisphosphonates!

Zolendronic acid
Alendronate
Risedronate

45
Q

Hpt jT mutation

A

Parafibromin /

CDC73 gene

46
Q

Marker of bone formation

A

Osteocalcin

47
Q

Nadir of calcium post oarathyroidectomy

A

24-36 hrs

48
Q

Biological actuvity of pth

A

Amino side

1-34 aas

49
Q

How many amino acids in PTH

A

84

50
Q

Cells with PTH receptors

A

Osteoblast

51
Q

calcium better absorbed

A

Calcium citrate

52
Q

Form of calcium that requires acidification

A

Calcium carbonate

53
Q

Highest calcium concent

A

Calcium carvinate 40% supplemental calcium

54
Q

Picture of pseudohypoparathyroidism

A

High PTH
Low ca
High phos ?

55
Q

When to do BMD

A

Women > /e to 65

Less than 65 or men with RF tor fracture

56
Q

Give RX in the osteopenic patients with what frax score

A

HIP fracture >= 3%

Or 20% major osteoporotic fracture

57
Q

Drug holiday

A

Low risk= drug holiday after 3-5 yrs of treatment

Higv risk= after 10 yrs
May use teriparatide or raloxifene during drug holiday

Reinitiate therapy when BMD decreases

58
Q

Spermarche

A

13.5

59
Q

% of testosterone from testes

A

95%

ENDOCRINE (12 decks)

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