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Int Spec (Ortho) > Bone Disease > Flashcards

Bone Disease Flashcards

1
Q

What is the most common causative organism of osteomyelitis?

A

Staph aureus

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2
Q

What group of individuals are prone to developing osteomyelitis with salmonella?

A

Sickle cell anaemia patients

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3
Q

What is the imaging modality of choice for an individual with suspected osteomyelitis?

A

MRI

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4
Q

What is the gold standard investigation for osteomyelitis?

A

Bone biopsy

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5
Q

What antibiotic treatment is usually given for osteomyelitis and how long for?

A

Flucloxacillin for 6 weeks

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6
Q

What antibiotic is given for osteomyelitis if the patient is penicillin allergic?

A

Clindamycin

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7
Q

What effect does parathyroid hormone have on calcium and phosphate levels?

A

Increased calcium and decreased phosphate

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8
Q

What effect does calcitonin have on calcium and phosphate levels?

A

Decreased calcium and decreased phosphate

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9
Q

What effect does vitamin D have on calcium and phosphate levels?

A

Increased calcium and increased phosphate

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10
Q

What effect does parathyroid hormone have on osteoblastic and osteoclastic activity?

A

Increased osteoclastic activity and decreased osteoblastic activity

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11
Q

Is osteoporosis a qualitative or quantitative defect of bone?

A

Quantitative (i.e. the bone is of normal quality, there just isn’t enough of it)

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12
Q

Anybody who has a fragility fracture should be screened for what condition?

A

Osteoporosis

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13
Q

What two screening tools can be used to assess an individual’s 10-year risk of a fragility fracture?

A

Q-fracture and FRAX

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14
Q

For osteoporosis to be diagnosed, an individual’s bone density must be what?

A

< 2.5 standard deviations below the mean

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15
Q

For osteopenia to be diagnosed, an individual’s bone density must be what?

A

1 - 2.5 standard deviations below the mean

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16
Q

What is meant by a) type 1 and b) type 2 osteoporosis?

A

a) post-menopausal osteoporosis, b) osteoporosis of old age

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17
Q

The use of which medication is most likely to cause secondary osteoporosis?

A

Steroids

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18
Q

What happens to calcium, phosphate and ALP in osteoporosis?

A

They are all normal

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19
Q

What investigation is used to diagnose osteoporosis?

A

DEXA bone scan

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20
Q

What supplements should be offered to all women diagnosed with osteoporosis?

A

Calcium and vitamin D

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21
Q

What is the first line treatment for osteoporosis?

A

Oral bisphosphonate (aledronate)

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22
Q

How is zoledronic acid given?

A

Once yearly IV injection

23
Q

How is denusomab given?

A

6 monthly subcutaneous injection

24
Q

25% of patients cannot tolerate an oral bisphosphonate due to what side effects?

25
How often are oral bisphosphonates given?
Once weekly
26
How do bisphosphonates work?
Inhibition of osteoclastic activity
27
How should patients be advised to take oral bisphosphonates?
On an empty stomach (at least 30 minutes before breakfast) and stand/sit upright for at least 30 minutes after taking
28
Osteonecrosis of the jaw can occur as a side effect of what medication?
Bisphosphonates
29
When should risedronate or etidronate be offered to patients with osteoporosis?
If they cannot tolerate aledronate
30
When should strontium or raloxifene be offered to patients with osteoporosis?
If they cannot tolerate bisphosphonates
31
When should women be given HRT as a treatment for osteoporosis?
Only if they also have vasomotor symptoms
32
What type of drug is raloxifene?
Selective oestrogen receptor modulator
33
Is osteomalacia a qualitative or quantitative defect of bone?
Qualitative
34
What is the underlying cause of osteomalacia and Rickett's?
Inadequate amounts of calcium and phosphate
35
What are the two principle causes of osteomalacia and Rickett's?
Decreased calcium absorption from the gut, and/or increased renal losses of phosphate
36
What are the three main features of osteomalacia/Rickett's?
Bony pain, deformities and pathological fractures
37
What happens to calcium, phosphate and ALP in osteomalacia/Rickett's?
Calcium and phosphate are low, ALP is high
38
What happens to PTH in osteomalacia/Rickett's?
High
39
How is osteomalacia/Rickett's treated?
Calcium and vitamin D supplementation
40
What type of hearing loss can Paget's disease cause?
Conductive
41
Which biochemical disease of bone can result in high-output cardiac failure?
Paget's disease
42
What happens to calcium, phosphate and ALP in Paget's disease?
Calcium and phosphate are normal, ALP is high
43
How is Paget's disease treated?
Bisphosphonates
44
What is the commonest benign tumour of bone, producing a bony outgrowth on the external surface of bone covered with a cartilagenous cap, most commonly around the knee?
Osteochondroma
45
Which benign tumour of bone typically occurs in the small tubular bones of the hands and feet?
Enchondroma
46
Intense, constant pain which is worse at night but is classically greatly relieved by NSAIDs describes which benign tumour of bone?
Osteoid osteoma
47
What is the most common primary malignant bone tumour?
Osteosarcoma
48
60% of cases of osteosarcoma affect where?
The bones around the knee
49
An 'onion-skin' pattern on plain radiography is suggestive of what malignant bone tumour?
Ewing's sarcoma
50
Which primary malignancy is associated with causing sclerotic bony metastases?
Prostate cancer
51
Which primary malignancy is associated with lytic 'blow out' bony metastases, which bleed tremendously with biopsy or surgery?
Renal cell carcinoma
52
How can bony metastases which are deemed not to be at risk of impending fracture be managed?
Radiotherapy and bisphosphonates
53
How is osteosarcoma treated?
Surgical resection and chemotherapy
54
How is Ewing's sarcoma treated?
Chemotherapy +/- surgery

Int Spec (Ortho) (10 decks)

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