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BDS3 BAMS > bone diseases > Flashcards

bone diseases Flashcards

1
Q

define arthritis

A

inflammation of joints

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2
Q

define arthrosis

A

non-inflammatory joint disease

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3
Q

define arthralgia

A

joint pain

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4
Q

what tissue forms bone?

A

mineralised connective tissue - load bearing, dynamic and self repairing

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5
Q

which cell resorbs bone?

A

osteoclasts

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6
Q

which cell deposits bone?

A

osteoblasts

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7
Q

where is calcium stored?

A

bone and teeth

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8
Q

how does parathyroid hormone affect serum calcium levels?

A

increase in parathyroid hormone when calcium levels fall to maintain serum calcium level

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9
Q

what effect does parathyroid hormone have on calcium release from bone and renal calcium excretion?

A

increases Ca release from bone
decreases renal Ca excretion

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10
Q

how does hypoparathyroidism affect serum calcium?

A

low serum calcium

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11
Q

how does primary hyperparathyroidism occur?

A

gland dysfunction for example a tumour leading to high serum calcium and inappropriate activation of osteoclasts

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12
Q

how does secondary hyperthyroidism occur?

A

low serum calcium levels leading to higher levels of parathyroid hormone to activate osteoclasts

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13
Q

what is the active version of vitamin D?

A

1, 25 dihyroxycolecalciferol

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14
Q

what vitamin is necessary for calcium and phosphate absorption in the gut?

A

vitamin D - active version 1, 25 dihydroxycolecalciferol

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15
Q

where can you get vitamin D?

A

sunlight
milk
orange juice
fish
supplements

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16
Q

what causes vitamin D problems ?

A

low sunlight exposure - housebound or dark skin
poor GI absorption due to nutrition to small intestine disease
drug interactions

17
Q

what is osteomalacia?

A

bone formed normally but poorly mineralised osteoid matrix and poorly mineralised cartilage growth plate - soft bone

18
Q

what is osteoporosis?

A

reduced quantity of normally mineralised bone
reduced bone mass
loss of mineral and matrix
age related and inevitable

19
Q

what is the result of osteomalacia during bone formation?

A

rickets disease

20
Q

what is the result of osteomalacia after bone formation?

A

osteomalacia

21
Q

osteomalacia and rickets are related to what deficiency?

A

calcium deficiency

22
Q

what is the effect of osteomalacia on bone clinically?

A

bones bend under pressure causing bow legs in children and vertebral compression in adults
bones ache

23
Q

when assessing osteomalacia serum calcium and serum phosphate are decreased if there is calcium deficiency but what is very high?

A

alkaline phosphatase - measure of bone turnover

24
Q

how is osteomalacia managed?

A

correct the cause - restore into diet or control GI disease
sunlight exposure 30min 5x weekly
dietary vitamin D

25
Q

describe some osteoporosis risk factors

A

age
female
endocrine - oestrogen and testosterone deficiency, cushings
genetic - family history
smoking
inactivity
poor dietary calcium
medications - steroids and antiepileptics

26
Q

describe some osteoporosis risk factors

A

age
female
endocrine - oestrogen and testosterone deficiency, cushings
genetic - family history
smoking and alcohol
inactivity
poor dietary calcium
medications - steroids and anti-epileptics

27
Q

what age does peak bone mass occur?

A

24-35 years

28
Q

what effect does oestrogen have on bone mass?

A

oestrogen withdrawal during menopause increases bone mass loss rate in women

29
Q

what are the effects of osteoporosis?

A

increased bone fracture risk
vertebrae - height loss, kyphosis (forward bend of spine), scoliosis and nerve root compression (back pain)

30
Q

how is osteoporosis prevented?

A

build maximal peak bone mass through exercise and dietary calcium intake
reduce the rate of bone mass loss by exercise and Ca intake
reduce hormone related effects through oestrogen HRT
reduce drug related effects
bisphosphonates - end in ronate - to prevent rate of bone loss

31
Q

what are the risks of oestrogen only HRT?

A

reduces risk of osteoporosis and ovarian cancer
increases risk of breast and endometrial cancer
increased DVT risk

BDS3 BAMS (11 decks)

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