Bone disease Flashcards
What is osteoporosis?
decreased bone mass and deterioration of bone which leads to increase fragility and fracture susceptibility
What happens inside the bone in osteoporosis?
decrease in connections between vertical trabecular and decreased strength and thickness
What is the bone remodelling cycle?
- osteoclasts resorb bone
- osteoclasts are replaced by osteoblasts which help to form new bone
What changes in the bone remodelling cycle in osteoporosis?
relative or absolute increase in resorption over formation so there is increased bone loss
What are the factors that regulate bone loss/bone mass?
- genetics
- sex hormones
- weight as underweight increases risk of osteoporosis
- diet
- exercise
- drugs especially glucocorticoids
What are the most common fracture sites for osteoporosis?
- NOF
- vertebral body
- distal radius
- humeral neck
What is used to assess bone density?
DEXA scans for lumbar spine which can be compared to determine extent of disease
What is osteoporosis classified as on a DEXA scan?
greater than 2.5 standard deviations from the mean
What are the first treatments for osteoporosis?
- weight loss
- smoking
- alcohol
- activity
What are the risk scorers for risk of osteoporosis related fractures?
- QFracture
- WHO fracture risk
What are the secondary causes of osteoporosis?
- Endocrine: hyperthyroid, Cushing’s
- GI: Coeliac, chronic liver disease/pancreas
- Respiratory: CF abd COPD
- Renal: chronic kidney disease
How much calcium is advised for a diet for someone with osteopororsis?
700mg
What are the drug treatments for osteoporosis?
- calcium and vit D supplements
- bisphosphonates
- denosumab
- teriparatide
- (HRT and testosterone)
What is the action of bisphosphonates?
these lead to osteoclast death so less bone resorption which prevents bone loss at all vulnerable sites (zoledronic acid is IV alternative)
What is the action of Denosumab?
- monoclonal antibody which inhibits osteoclasts
- 6 monthly injection
- decreases vertebral fracture risk
