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MSK Revision > Bone Disease > Flashcards

Bone Disease Flashcards

1
Q

What is the definition of Osteoporosis?

A

Metabolic bone disease characterised by low bone mass and micro architectural deterioration of bone leading to increased risk of fractures, the bone is 2.5 SD away from being healthy

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2
Q

What are the secondary causes of osteoporosis?

A 
Hyperparathyroidism 
Gh deficiency 
Malabsorption 
Malignanc 
Rheumatic drugs 
Amenorrhea
Oestrogen Deficiency
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3
Q

What is the pathogenesis of osteoporosis?

A

Increased breakdown by osteoclasts and decreased production by osteoblasts

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4
Q

What is the presentation of Osteoporosis?

A

Fractures on low impact
Asymptomatic
Crushed vertebra Colles’s fractures

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5
Q

What is the GOLD standard investigation on osteoporosis? What does this scan look at?

A

Dexa Bone Scan

Bone mineral density

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6
Q

What are some other investigations to do in osteoporosis?

A

Plain radiograph

FBC’s

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7
Q

What are the prophylactic measures in OP?

A

HRT
Physiotherapy
Stop smoking and alcohol
Calcium and vitamin D for those on steroids

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8
Q

What are the 4 medical management options for osteoporosis?

A 
Biphosphonates
Vitamin D/ calcium 
Raloxifene
Strotium ranelate
Risk factor assessment
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9
Q

What is Rickets?

A

Severe vitamin D or calcium nutritional deficiency in children
Before the epiphyseal plates have closed

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10
Q

What is osteomalacia?

A

Severe vitamin D or calcium nutritional deficiency in Adults
After the epiphyseal plates have closed

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11
Q

What is the most common cause of rickets?

A

Lack of phosphate or vitamin D deficiency

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12
Q

What are the clinical features of rickets?

A

Stunted growth, curve in the spine, wide bones

Bowed legs

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13
Q

What are the clinical features of Osteomalacia?

A

Joint and bone pain, muscle weakness, abnormal gait, low calcium features = irregular heart, numbness and muscle spasms

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14
Q

what are your investigations for these 2?

A

Serum Vit D, Calcium, phosphate, PTH
X-ray
Bone biopsy

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15
Q

What are the managements?

A

Oral calcium and vitamin D

Bone correction surgery

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16
Q

What is Pagets Disease?

A

This is a disorder of bone remodelling after an initial event of excessive reabsorption, this leads to disorganised bone with more vascualtoyt and less compact meaning it can be fractures more easily

17
Q

What are the causes of Paget’s disease?

A

This is familial in 30%

Can be caused by an environmental trigger

18
Q

What bones are most commonly involved?

A

Femoral, pelvis and skull

19
Q

What is the presentation of Paget’s disease

A 
This is a condition in the over 40's, who have:
Bone pain and deformity 
Excessive heat over the bone 
Neurological complications 
Can be complicated by osteosarcoma
FH of pagers disease
20
Q

What is THE diagnostic test in pagets disease?

A

Raised SERUM ALKALINE PHOSPHATASE
Bone Scan
X-ray/ bon biopsy

21
Q

What is the management of Paget’s bone disease?

A

Minimal unless skull involvement

IV biphosphonate

22
Q

What is osteogenesis Imperfecta

A

This is genetic connective tissue disorder where there is very fragile bones form mild trauma and daily living

23
Q

What are the 4 types of OI?

A

1 = mild, presents in adults
Type 2 = can be lethal by age 1
3 = more severe and progressive
4 = adults but very severe very quickly

24
Q

What re the clinical features of OI?

A 
Growth deficiency 
Defective tooth formation 
Hearing loss
Blue sclera
Barrel chest
Easy bruising 
OI
25
Q

What is the clinical diagnosis and management of OI?

A

Skin biopsy and genetic testing

IV biphosphonates and that the fractures surgically

26
Q

What is Marfan’s syndrome?

A

This is an autosomal DOMINANT condition in which there is loss of the elastic tissue

27
Q

What is the cause of Marfan’s syndrome?

A

This is due to a defect in the fibrillar gene

28
Q

What are the 3 diagnostic areas that are affected in Marfan’s syndrome?

A

MSK
Cardio
Occular

29
Q

What MSK symptoms are seen in Marfan’s syndrome?

A 
Caved chest
Long and Thin limbs 
Scoliosis 
Thumb sign 
Back ache
30
Q

What ocular symptoms are seen in Marfan’s syndrome?

A

Myopia and retinal detachment

31
Q

What Cardio symptoms are seen in Marfan’s syndrome?

A

Aortic aneurysm - Dilatation/ dissection
Aortic/mitral valve murmur
Pneumothorax

32
Q

What are the managements for Marfan’s Syndrome?

A 
Antihypertensives
Aortic root Sx
Mechanical valve insertion 
Surgery for ocular symtoms 
Myopia = corrective lens 
Physio and analgesia

MSK Revision (14 decks)

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