Bone disease

Question 1

what is arthritis ?

Answer 1

inflammation of joints

Question 2

what is arthrosis?

Answer 2

non-inflammatory joint condition

Question 3

what is athralgia?

Answer 3

joint pain

Question 4

what are the components of bone?

Answer 4

-calcium
-vit D
-phosphate

Question 5

what is stored in bone?

Answer 5

calcium- exchangeable and non exchangeable

Question 6

what controls calcium serum levels in blood?

Answer 6

the parathyroid

Question 7

what is hypoparathyroidism?

Answer 7

low calcium serum levels

Question 8

what is hyperparathyroidism?

Answer 8

high calcium serum levels due to primary or secondary failure

Question 9

what is hyperparathyroidism?

Answer 9

high calcium serum levels
- inappropriate activation of osteoclastic bone resorption to remove calcium from bone into blood

Question 10

how does the parathyroid control calcium serum levels ?

Answer 10

-increases vit d
-reduces calcium renal excretion
-promotes bone loss- by taking calcium from bone into blood

Question 11

what does the parathyroid release?

Answer 11

PTH

Question 12

how can you increase vitamin D?

Answer 12

-sun exposure
-fish
-oranges

Question 13

why might their be a vitamin d deficiency ?

Answer 13

-low sun exposure
-GI disease
-malnutrition
-drugs interactions eg epileptic drugs

Question 14

what can calcium deficiencies cause?

Answer 14

osteomalacia and osteoporosis

Question 15

what is osteomalacia?

Answer 15

poorly mineralised bone

during bone formation- rickets
after bone formation- osteomalacia (vertebral compression in adults )

Question 16

what are the effects of osteomalacia and how is it treated?

Answer 16

soft malleable bone that bends under pressure- rickets/vertebral compression

-correct the cause eg malnutrition/GI disease
-dietary vit d and calcium
-sun exposure

Question 17

what is osteoporosis?

Answer 17

reduced quantity of normally mineralised bone i.e reduced bone mass

INEVITABLE AND AGE RELATED CHANGE

Question 18

what are the risk factors of osteoporosis ?

Answer 18

inevitable
- age
-female (oestrogen and testosterone deficiency)
-inactivity
-smoking
-alcohol
-cushings (inc corticosteroids)
-genetics/family history
-poor calcium in diet

Question 19

why is osteoporosis more common in female than males?

Answer 19

-because males have a higher peak bone mass
-oestrogen withdrawal in menopausal women increases bone mass loss
-peak bone mass in ages 24-35

Question 20

what are the effects of osteoporosis?

Answer 20

• fractures- hip and wrist commonly
  (hip inc mortality as fully dependent)
• height loss- kyphosis and scoliosis
• nerve root compression- back pain

-lifetime risk of hip fracture
-hip fracture- unable to walk or live independently

Question 21

how can you prevent osteoporosis?

Answer 21

-reach higher peak bone mass as it will take longer to cause osteoporotic effects
-exercise, vit d and calcium dietary intake
-bisphosphonates
-hormone replacement therapy (oestrogen)

Question 22

what is HRT?

Answer 22

-hormone replacement therapy- oestrogen therapy reduces osteoporosis risks but increases risk of other conditions
-if stopped benefits stop after 5 years

Question 23

what are bisphosphonates ?

Answer 23

“ates”
-slow rate of bone loss
-reduces no of osteoclasts and stop their action
-example = alendronate
-very effective at reducing fracture risk
-if IV- major problem with dental extractions- osteonecrosis -MRONJ (as osteoclasts needed for bone healing)