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Y2 MSK > Bone Diseases > Flashcards

Bone Diseases Flashcards

1
Q

Osteoporosis is a quantitative/ qualitative disease

A

Quantatitive

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2
Q

What are the main clinical features of osteoporosis?

A

Reduced bone mineral density

Increased porosity

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3
Q

How is osteoporosis clinically defined?

A

< 2.5 sd. below the mean for young adults

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4
Q

What is the intermediate stage of osteoporosis defined as?

A

Osteopenia

1-2.5 s.d

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5
Q

Give the two main types of osteoporosis and clinical features of each

A
  1. Post-menopausal (reduced oestrogen levels)
    Colles fractures, vertebral insufficiency
  2. Old age (chronic disease and low vitamin D)
    Femoral neck and vertebral fractures
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6
Q

What are some risk factors for the development of osteoporosis

A 
Smoking
Alcohol
Reduced exercise
Diet
CCS
Malnutrition
CKD
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7
Q

In type 2 osteoporosis, cells are found…

A

On the surface of bone

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8
Q

Osteochondritis is mainly found in…

A

Children

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9
Q

What is the aetiology of osteochondritis?

A

Increased activity and stress on bone leads to bleeding and oedema

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10
Q

Outline the treatment for osteochondritis

A

Osteotomy

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11
Q

What investigation is typically used to diagnose osteoporosis and what are the results?

A

DEXA scan
Reduced bone mineral density
Ca and PO4 normal

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12
Q

Outline the management options for osteoporosis

A 
Exercise
Diet
Ca and Vit D supplements
HRT
Anti-resorptive drugs
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13
Q

What is the first line anti-resorptive drug used in osteoporosis? What are the alternatives?

A

Biphosphonates e.g. alendroate

Desonumab, strontium

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14
Q

What is the mechanism of action of anti-resorptives?

A

Reduce osteoclast activity

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15
Q

Osteomalacia and rickets are quantitative/ qualitative diseases

A

Qualitative

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16
Q

Osteomalacia and rickets are mainly found in…

A

Children

17
Q

What are the main clinical features of osteomalacia and rickets?

A

Abnormal bone softening due to reduced minerals of osteoid (inadequate Ca and PO4)

18
Q

What are the classical symptoms and signs described in osteomalacia and rickets?

A

Bone pain
Soft bone deformity
Increased fractures
Hypocalcaemia (paraesthesia, cramps, irritability, fatigue, seizures, brittle nails)

19
Q

Osteoporosis leads to…

A

Bone fragility and fractures

20
Q

What investigations are used in the diagnosis of osteomalacia and rickets? What results would you expect)

A

Radiograph (‘Loosers zones’)

Serum bone biochemistry (Low Ca and PO4)

21
Q

Outline the management for osteomalacia and rickets

A

Vit D and Ca and PO4 supplements

22
Q

Outline the three main types of hyperparathryoidism and the biochemistry for each

A

PRIMARY: Increased Ca, increased PTH
SECONDARY Reduced Ca (hypocalcaemia), increased PTH
TERTIARY: Chronic secondary HPTM leading to increased Ca, increased PTH

23
Q

List the main causes of primary hyperparathyroidism

A

Benign adenoma
Malignancy
Hypercalcaemia

24
Q

Outline the management for hyperparathyroidism

A

Remove adenomatous gland
IV fluids
Biphosphonates
Calcitonin

25
Q

What is Paget’s disease?

A

Paget’s disease of bone interferes with your body’s normal recycling process, in which new bone tissue gradually replaces old bone tissue. Over time, the disease can cause affected bones to become fragile and misshapen

26
Q

What are the main clinical features of Paget’s disease?

A

Increased osteoclast activity leading to increased osteoblast activity, this results in the formation of new bone that doesn’t remodel well

27
Q

Which viral infection can cause Paget’s disease?

A

Paramyoxyvirus

28
Q

Paget’s disease is usually asymptomatic and detected on XR. True/ False?

A

True

29
Q

Which bones does Paget’s disease usually affect?

A

Pelvis
Femur
Skull
Tibia

30
Q

What investigations are used in the diagnosis of Paget’s Disease?

A

Radiography

Bone scans

31
Q

What bone biochemistry would suggest a diagnosis of Paget’s Disease?

A

Increased ALP

Ca and PO4 normal

32
Q

Outline the management options for Paget’s Disease

A

Biphosphonates
Calcitonin
Joint fractures
Skeletal stabilization

33
Q

What is AVN?

A

Ischaemic bone necrosis/ disrupted blood supply leading to pathological fractures

34
Q

Where is AVN most common in the body?

A

Femur head

Scaphoid bone

35
Q

List some risk factors for AVN

A

Chronic alcoholism
Steroid abuse
High cholesterol
Osteoarthritis

36
Q

How is AVN diagnosed? What results would you expect?

A

MRI

Large wedge-shaped discolouration, creeping substitution

37
Q

Outline the management options for AVN?

A

Joint replacement

Arthrodesis

Y2 MSK (30 decks)

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