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BDS3 Human Systems > Bone Disease > Flashcards

Bone Disease Flashcards

1
Q

What is the definition of arthritis?

A

Inflammation of Joints

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2
Q

What is the definition of arthrosis

A

non-inflammatory joint disease

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3
Q

what is arthralgia

A

joint pain

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4
Q

Describe Bone

(also,what does bone require to repair)

A
  • mineralised connective tissue
  • load bearing
  • dynamic (constantly remodelling and self repairing)
  • requires calcium, phosphate and vitamin D to repair
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5
Q

How do bone and calcium interact>

A
  • if systemic calcium is low, bone will resorb to release calcium into blood
  • caused by an increase in parathyroid hormone
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6
Q

What is the relation between parathyroid hormone and bone?

A
  • maintains serum calcium level (raised if calcium levels fall)
  • increases calcium release from bone
  • reduces renal calcium excretion
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7
Q

What is primary hyperparathyroidism and what is its effect?

A

-gland dysfunction (often caused by a tumour)
- increased secretion of PTH
- inappropriate activation of osteoclasts
- increased bone resorption

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8
Q

What does hypoparathyroidism result in ?

A

low serum calcium

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9
Q

What is secondary hyperparathyroidism and what is its effect?

A
  • low serum calcium triggers
  • increased secretion of PTH
  • appropriate activation of osteoclasts
  • regulates serum calcium
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10
Q

What causes low levels of vitamin D?

A

low sunlight exposure (housebound or dark skinned in northern country)

poor GI absorption (poor nutrition, small intestinal disease (malabsorption)

drug interactions (anti-epileptics)- Carbamazepine

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11
Q

What is an osteomalacia

A
  • poorly mineralised osteoid matrix
  • poorly mineralised cartilage growth plate
  • bone is plaible and soft
  • normal amount of formation of bone
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12
Q

What is osteoporosis?

A
  • loss of mineral and matrix
    (formation is correct but reduced quantity)
  • REDUCED bone mass
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13
Q

What is rickets?

A

osteomalacia that forms during bone formation

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14
Q

What are the bone effects of osteomalacia ?

A

bones bend under pressure

  • ‘bow legs’ in children
  • vertebral compression in adults
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15
Q

What are the affects of hypocalaemia?

A
  • muscle weakness
  • carpal muscle spasm
  • facial twitching from VII tapping
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16
Q

How does osteomalacia present in a blood test?

A
  • serum calcium DECREASED
  • serum phosphate DECREASED
  • alkaline phosphatase HIGH
  • plasma creatine INCREASE (if renal cause)
  • plasma parathyroid hormone INCREASE (if secondary hyperparathyroidism)
17
Q

What is osteoporosis and who would it generally effect?

A

a reduced quantity of normally mineralized bone

  • age related change
  • inevitable
17
Q

How do you manage osteomalacia?

A
  • correct the cause

malnutrition (control GI disease)

Sunlight exposure (30min x5 weekly)

Dietary - Vitamin D

18
Q

What are the key risk factors for osteoporosis?

A
  • age
  • female
  • endocrine (oestrogen/testosterone deficiency, cushings)
  • genetic (FH, race (caucasian and asian woman), early menopause)
  • patient factors, (inactivity, smoking, alcohol abuse, poor dietary calcium)
  • medical drugs use (steroids and antiepileptics)
19
Q

What age is peak bone mass

A

24-35 years old

20
Q

Why is osteoporosis more common in woman?

A
  • males have higher peak bone mass
  • oestrogen withdrawal (menopause) increases bone mass loss rate in woman
21
Q

What are the noticeable effects of osteoporosis ?

A
  • increases bone fracture risk (long bones- femur)
  • vertebrae (height loss, scoliosis/kyphosis, nerve root compression resulting in back pain)
22
Q

What are the effects of osteoporosis STATS

A
23
Q

How can osteoporosis be prevented?

A
  • build maximal peak bone mass (exercise, high calcium diet)
  • reduce rate of bone mass loss

reduce hormone related effects (eostrogen hormone replacement therapy, effective if early menopause)

reduce drug related effects

consider osteoporosis prevention drugs
- BISPHOSPHONATES

24
Q

How does hormone replacement therapy work?

A
  • oestrogen only

-most effective during early menopause
- loses effect 5 years after stopping
- increased breast, endometrium,
- reduced ovarian cancer risk
- increased DVT risk

25
Q

What are bisphosphonates?

A
  • drugs that act to reduced osteoclast activity by poisoning them
  • reduced osteoclasts = reduced bone loss
26
Q

What are the most common bisphosphonates?

A

alendronate

risedronate

CAN be combined with hormone replacement therapy

  • benefit lost if drug discontinued

BDS3 Human Systems (6 decks)

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