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Endocrinology > Bone Disorders > Flashcards

Bone Disorders Flashcards

1
Q

what destroys bone?

A

osteoclasts

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2
Q

what rebuilds bone?

A

osteoblasts

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3
Q

female bone mass significantly reduces at what age/stage?

A

menopause

50s/60

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4
Q

what 2 classes of drug results in bone loss?

A

glucocorticoids and aromatase inhibitors

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5
Q

name the 4 common fracture sites

A

neck of femur
vertebral body
distal radius
humeral neck

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6
Q

those with osteoporosis often have thoracic ______sis

A

those with osteoporosis often have thoracic KYPHOSIS

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7
Q

what scan is performed to measure bone mass?

A

DEXA scan

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8
Q

normal
osteopenia
osteoporosis
severe osteoporosis

BMD ≥ 2.5 SD below the young adult mean

A

osteoporosis

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9
Q

normal
osteopenia
osteoporosis
severe osteoporosis

BMD within 1 SD of the young adult reference mean

A

normal

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10
Q

normal
osteopenia
osteoporosis
severe osteoporosis

BMD >1 SD below the young adult mean but <2.5 SD below this value

A

osteopenia

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11
Q

normal
osteopenia
osteoporosis
severe osteoporosis

BMD ≥2.5 SD below the young adult mean with fragility fracture

A

severe osteoporosis

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12
Q

if younger than 20, what is the only thing reported?

A

z score

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13
Q

who should be referred for DEXA?

A

patients over 50
low trauma fracture

10 year risk assessment for any OP fracture of at least 10%

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14
Q

name the risk assessment tool for increased risk of fracture

A

FRAX or Qfracture

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15
Q

WHO fracture risk calculator allows prediction of __ year fracture risk of major osteoporotic fracture or hip fracture

A

WHO fracture risk calculator allows prediction of 10 year fracture risk of major osteoporotic fracture or hip fracture

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16
Q

those under the age of 50 that have undergone early ________ or on _______________ should be assessed

A

those under the age of 50 that have undergone early MENOPAUSE or on GLUCOCORTICOIDS should be assessed

17
Q

lifestyle advice for management of osteoporosis?

A

strength training
avoidance of alcohol
avoidance of smoking
fall prevention

18
Q

how much calcium in those with osteoporosis should they get?

A

700mg calcium (2-3 portions)

postmenopausal women - 1000mg calcium

19
Q

what 2 supplements should those with osteoporosis receive?

A

calcium and vitamin D

20
Q

name the drug class prescribed in osteoporosis that prevent bone loss at all sites vulnerable to osteoporosis

A

biphosphonates - alendronate and risedronate

target osteoclast activity

reduce risk of hip and spine fractures

21
Q

long term concern of biphosphonate therapy?

A

osteonecrosis of the jaw

GI upset

22
Q

what is an alternative to biphosphonates due to GI upset?

A

zoledronic acid

once yearly IV infusion for 3 years

23
Q

name the monoclonal antibody that inhibits development and activity of osteoclasts

A

denosumab

SC injection 6 monthly

24
Q

adverse effects of densomab?

A

hypocalcaemia
eczema
cellulitis

25
Q

name the recombinant hormone that stimulates bone growth rather than reduce bone loss

A

teriparatide

used in those who can’t tolerate oral treatment

26
Q

corticosteroids ______ osteoblast activity and calcium absorption

A

corticosteroids REDUCE osteoblast activity and calcium absorption

also inhibit gonadal and adrenal steroid production

27
Q

name the following disease:

abnormal osteoclastic activity followed by increased osteoblastic activity

A

paget’s disease

abnormal bone structure with reduced strength and increased fracture risk

28
Q

what type of bones does pagets affect?

A

long bones

also pelvis, lumbar spine and skull

29
Q

what causes pagets?

A

viral/environmental/biochemical trigger in genetically predisposed individuals

30
Q

what does pagets present with?

A

bone pain, deformity, deafness, compression neuropathies

31
Q

biochemistry of pagets:

high what?

A

ALP - alkaline phosphatase

32
Q

how do you diagnose pagets?

A

high ALP and XR

33
Q

pagets treatment?

A

biphosphonates

34
Q 
rare
children
fracture
blue sclera
dentinogenesis imperfecta

diagnosis?

A

Osteogenesis Imperfecta

autosomal dominant
mutations in collagen genes

35
Q

Osteogenesis Imperfecta cure?

A

no cure

fracture fixation, surgery and biphosphonates

DHx for suspected non-accidental injury

Endocrinology (31 decks)

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