Bone Disease

Question 1

What is arthritis?

Answer 1

Inflammation of joints

Question 2

what is arthrosis?

Answer 2

non-inflammatory joint disease

Question 3

what is arthralgia?

Answer 3

joint pain

Question 4

What function does Parathyroid Hormone play in bone?

Answer 4

Maintains serum calcium levels. Increases if Ca levels fall. Increases calcium release from bone and decreases calcium excretion from the renal system.

Question 5

What role does Vitamin D play in bone levels?

Answer 5

Vitamin D helps absorb Calcium from the digestive system.

Question 6

Why might someone have low vitamin D?

Answer 6

• Low sunlight exposure
• Poor GI absorption
• Drug Interactions

Question 7

What is Osteomalacia?

Answer 7

Poorly mineralised osteoid matrix

Poorly mineralised cartilage growth plate

Question 8

what is Osteoporosis?

Answer 8

Loss of mineral and matrix

Reduced bone mass

Question 9

what is the name of the childhood condition related to osteomalacia before bone has finished forming?

Answer 9

rickets

Question 10

describe the physical appearance of osteomalacia in children and adults.

Answer 10

• bow legs in children
• Vertebral compression in adults
• sore bones

Question 11

what are the symptoms of Hypocalcaemia?

Answer 11

Muscle weakness
Trousseau & Chvostek signs positive
Carpal muscle spasm
Facial twitching from VII tapping

Question 12

What blood test results might one see in someone with osteomalacia?

Answer 12

• decreased serum calcium
• decreased serum phosphate
• very high alkaline phosphate
• Increased plasma creatine if the cause is renal
• increased plasma parathyroid hormone if secondary hyperparathyroidism is the cause

Question 13

How do we manage osteomalacia?

Answer 13

• Control GI Disease
• Sunlight exposure (30 mins 5x per week)
• Dietary Vitamin D

Question 14

What are the risk factors for osteoporosis?

Answer 14

*AGE
*Female sex
*Endocrine - Oestrogen & testosterone deficiency/
Cushings syndrome
*Genetic - Family history /Race – caucasian & asian women / Early menopause
*Patient factors - Inactivity/Smoking//Excess alcohol use/Poor dietary calcium
*Medical Drugs use - steroids/antiepileptics

Question 15

At what age do we achieve peak bone mass?

Answer 15

24-35 years

Question 16

Why is osteoporosis more common in women?

Answer 16

its linked to oestrogen withdrawal.

Question 17

what are the effects of osteoporosis?

Answer 17

• Increased bone fracture risk - Long bones – femur
• Vertebrae - Height loss/Kyphosis & Scoliosis/Nerve root compression – back pain
• Lifetime risk of hip fracture >50yrs of age
• After osteoporosis related hip fracture
• problems being able to walk unaided or live independantly

Question 18

How can osteoporosis be prevented?

Answer 18

• Build peak bone mass by exercise and high dietary calcium intake
• reduce rate of bone mass loss via exercise and calcium intake and reduce hormone related effects.
• Reduce drug related effects
• osteoporosis prevention drugs - Bisphonates

Question 19

What are the pros and cons of oestrogen replacement therapy to treat osteoporosis?

Answer 19

• Reduces osteoporosis risk
• Increases breast cancer risk
• increases endometrial cancer risk