Bone Diseases (3)

Question 1

Red S syndrome- cause and s/s

Answer 1

<300 cals/day can trigger it

s/s- stress fx, shin splints, menstrul loss in F, low test in M

Question 2

Main marker for bone breakdown

Answer 2

Urine telopeptides

Question 3

Main marker for bone buildup

Answer 3

Serum alkaline phosphatase (ALP)

Question 4

Main tests used in bone diseases (4)

Answer 4

Serum Calcium
Serum Albumin
Serum Phosphate
Serum Alkaline phosphatasee

Question 5

How does parathyroid hormone, kidney function, intestinal function regulate calcium

Answer 5

parathyroid hormone- pulls calc from bone
kidney function- retains calc
intestinal function- final loc of vit d activation
thyroid hormone

Question 6

hypocalcemia s/s + causes (mc)

Answer 6

tetany, mm weakness

causes- hypoparathyroidism, vit d def, kidney disease( MC)

Question 7

testing algorithm for hypocalcemia

Answer 7

if calc<2.1
yes= kidney diseas

=no- measure PTH

Question 8

hypercalcemia- s/s, causes (mc)

Answer 8

s/s- drowsy, gastro pain, cardiac arrhythmias, hypertension

causes- hyperparathyroidism (mc), vit D excess

Question 9

Hypercalcemia testing

Answer 9

if calc >2.8 check PTH

Question 10

serum plasma phosphate/phosphorus in relation to calc

Answer 10

Reciprocal relation w calc

enters cell w glucose- will be low w diabetes

Question 11

Hypophosphatemia- S/s, tests, disease causes

Answer 11

s/s- mm pain+ weakness
tests- serum phosphate
diseases- hyperparathyroidism, vit d def

Question 12

hyperphosphatemia- s/s, disease causes

Answer 12

s/s- calc phosphate deposition in soft tissues

disease causes- kidney failure (mc)- low calc in kindey failure causes incrrease in phos

Question 13

what does serum Mg influence

Answer 13

influences secretion of PTH by parathyroid (need it to secrete PTH)

Question 14

hypomagnesaemia- mc cause + s/s

Answer 14

mc cause- starvation

s/s- tetany, hyperirritabty, tremor

Question 15

hypermagesaemia- disease causes, S/s

Answer 15

kidney failure/iatrogenic

s/s- centreal nervous system toxicity, mm toxicity

Question 16

When is deoxypyridinoline released

Answer 16

during bone resorption cross links are released into blood

Question 17

when i vit D/ calcitriol increased + decreased

Answer 17

increased- hyperparathryoidism, hypervitaminosis D

decreased- liver failure, hypoparathyriodism

Question 18

Effects of vit d3/ calcitriol on intestine/kidney/bone

Answer 18

bone= calcium/phosphate transport increased

Kidney= prox tubule vit D3 prod dec, distal tubule calcium resporbtion increased

bone= osteoprogentors to osetoclasts

Question 19

when is calcitonin released and what does it do

Answer 19

released in response to increased plasma calcium

• decreases osteoclastic breakdown
• decreases absorbtion of calcium + phosphate

Question 20

osteoperosis tests

Answer 20

CBC- look for signs of malnutrition
Serum ALD, calc, phosphate, creatine, TSH
Serum vit D

Question 21

Pagets disease test

Answer 21

Serum ALP much increased

Question 22

primary and secondary causes of hyperparathyroidism

Answer 22

primary= usually benign adenoma
secondary= Vit D/chronic kidney disease