bone disorders

Question 1

what is osteoporosis and osteopenia?

Answer 1

osteopenia precursor to osteoporosis

= its when imbalance between bone resorption & formation meaning decreased bone mass (weak bones)

Question 2

what are T scores and Z scores?

Answer 2

T-scores = comparing to young healthy adult

Z-score = compare to same age & gender

*remember as Z looks like “ = ”

Question 3

what scan to measure bone density?

Answer 3

DEXA scan

Question 4

what is function of osteoclast and osteoblast?

Answer 4

osteoclast = resorbs bone (process where bone broken down and dissolved, releasing calcium & phosphate in blood)

osteoblast = lays down new bone

Question 5

what is function of bisphosphonate drug?

Answer 5

inhibits osteoclast activity (so stops bone resorption)

Question 6

what is osteopetrosis?

Answer 6

rare genetic disorder where abnormal hardening of bones from defective osteoclasts

Question 7

what is osteomalacia?

Answer 7

poor bone mineralisation due to vit D deficiency = softening of bones

Question 8

what are investigation results of osteomalacia?

Answer 8

low calcium, low phosphate, high ALP, high PTH

Question 9

what are symptoms of osteomalacia?

Answer 9

bone pain, muscle weakness, waddling gait, hypocalcemia signs

Question 10

what are investigation results for osteoporosis?

Answer 10

normal calcium, normal phosphate, normal ALP, normal PTH

Question 11

what is rickets?

Answer 11

osteomalacia in kids. bone demineralisation

Question 12

what are symptoms & bone deformities of rickets?

Answer 12

• lethargy
• bone pain
• poor growth
• dental problems
• swollen wrists

bone deformities = bowing legs, genu valgum, delayed teeth, craniotabes (deformed skull)

Question 13

what are lifestyle factors for osteoporosis?

Answer 13

• high intensity strength training
• low impact weight bearing exercise (always 1 foot on floor)
• avoid excess alcohol
• avoid smoking
• at least 700 mg calcium 1000 mg post menopausal)

Question 14

what are the 2 important supplements for osteoporosis?

Answer 14

calcium & vit D supplements (can help reduce risk of non-vertebral fractures especially if insufficient dietary intake or low sun exposure). don’t absorb calcium well if vit D deficient

(if calcium diet sufficient, more than 700 mg, then just vit D)

Question 15

what are drug options for osteoporosis treatment?

Answer 15

1. bisphosphonates e.g. alendronate or risedronate (ingested by osteoclasts so prevent bone resorption)
2. denosumab (inhibits RANKL which inhibits osteoclast development)
3. teriparatide - for severe osteoporosis
4. romosozumab (humanised monoclonal - if previous fracture & at high risk)

Question 16

what T score suggests treatment needed?

Answer 16

T score 2.5 or less

Question 17

what fracture type is associated with significant mortality and morbidity?

Answer 17

neck of femur fracture