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Y2 Endocrine > Bone Disorders > Flashcards

Bone Disorders Flashcards

1
Q

what are the three main types of bone cells?

A

osteoclasts
osteoblasts
osteocytes

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2
Q

what do osteoclasts do?

A

responsible for bone resorption

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3
Q

what do osteoblasts do?

A

responsible for bone formation

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4
Q

what is the primary cell of mature bone?

A

osteocytes

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5
Q

name five factors that affect the ability to achieve peak bone mass

A 
genetics 
being underweight 
sex hormones
diet 
exercise
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6
Q

name six factors that increase the rate of physiological bone loss

A 
sex hormone deficiency 
body weight 
diet 
immobility 
disease 
drugs
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7
Q

what two types of drugs increase rate of physiological bone loss?

A

glucocorticoids

aromatase inhibitors

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8
Q

when is peak bone mass usually attained?

A

around 30

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9
Q

when does age related bone loss start?

A

around 50

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10
Q

what is it called when the bone mass stays stable?

A

consolidation

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11
Q

what causes a steep decline in bone mass in women?

A

menopause

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12
Q

who has a higher bone mass throughout life - males or females?

A

males

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13
Q

what is the major determinant of bone loss in women after the menopause?

A

oestrogen deficiency

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14
Q

what are four common fracture sites in osteoporosis?

A

neck of femur
vertebral body
distal radius
humeral neck

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15
Q

name two tools that can be used to assess fracture risk in osteoporosis?

A

QFracture

FRAX

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16
Q

name some non modifiable risks for osteoporotic fractures

A 
age 
gender 
previous fractures 
family history 
early menopause
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17
Q

name some modifiable risks for osteoporotic fractures

A 
bone mineral density 
alcohol 
weight 
smoking 
inactivity
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18
Q

who should be assessed for osteoporosis?

A

> 50 with any risk factors

< 50 with very strong risk factors

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19
Q

what are the very strong risk factors for osteoporosis?

A

early menopause

glucorticoids

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20
Q

how should be referred for a DEXA scan?

A

patients with 10 year risk for osteoporotic fractures >10%

21
Q

what is the most common method for measuring BMD?

A

DEXA scan

22
Q

what two areas are scanned in a DEXA scan?

A

L1-L4

non dominant hip

23
Q

what is the Z score in a DEXA scan?

A

their BMD compared to the peak in a young population - assesses whether loss is age appropriate

24
Q

what is the T score in a DEXA scan?

A

BMD compared to their own age group

25
Q

what is normal on a DEXA scan?

A

BMD within 1SD of the young adult reference mean

26
Q

what is osteopenia on a DEXA scan?

A

BMD >1SD below the young adult mean

27
Q

what is osteoporosis on a DEXA scan?

A

BMD >2.5SD below the young adult mean

28
Q

what is severe osteoporosis on a DEXA scan?

A

BMD >2.5SD from young adult mean alongside a fracture

29
Q

what lifestyle advice is given for osteoporosis?

A

strength training
low impact exercise
alcohol and smoking avoidance
fall prevention - OT

30
Q

what mineral do people with osteoporosis need to eat more than average of?

A

calcium

eat 1000mg a day

31
Q

what is the first line drug management of osteoporosis?

A

calcium + vit D supplements

bisphosphonates

32
Q

when can calcium supplements not be taken?

A

within 2 hours of bisphosphonates

33
Q

how do bisphosphonates work?

A

anti resorptive agents - preventing bone loss

34
Q

name two bisphosphonates

A

alendronate

risedronate

35
Q

what are the complications of long term use of bisphosphonates?

A

osteonecrosis of the jaw
oesophageal carcinoma
atypical fractures

36
Q

what are the possible second line drugs for osteoporosis?

A

zoledronic acid
denosumab
teriparatide
romosozumab

37
Q

what should be considered in patients with early menopause tor reduce fracture risk?

A

HRT

38
Q

what is the pathophysiology of Paget’s disease of bone?

A

initially normal bone resorption followed by increased bone formation

= results in abnormal structure with reduced strength

39
Q

what is it called when Paget’s disease of bone affects one site?

A

monostotic

40
Q

what is it called when Paget’s disease of bone affects more than one site?

A

polyostotic

41
Q

where does Paget’s disease of bone usually affect?

A

long bones
pelvis
lumbar spine
skull

42
Q

how does Paget’s disease of bone present?

A

bone pain
deformity
deafness
compression neuropathies

43
Q

what is a rare complication of Paget’s disease of bone?

A

osteosarcoma

44
Q

how is Paget’s disease of bone diagnosed?

A

x-ray
isotope bone scan
bloods

45
Q

what is seen on bloods in Paget’s disease of bone?

A

raised ALP

46
Q

how is Paget’s disease of bone managed?

A

analgesia

bisphosphonates

47
Q

what is osteogenesis imperfecta?

A

group of genetic disorder affecting bone

48
Q

what can osteogenesis imperfecta be associated with?

A

blue sclerae

dentinogenesis imperfecta

49
Q

how is osteogenesis imperfecta managed?

A

fracture fixation
surgery for deformities
bisphosphonates

Y2 Endocrine (33 decks)

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