Bone Disorders

Question 1

The early stages of Osteoporosis are:

Answer 1

asymptomatic

Question 2

How can a microorganism that causes Osteomyelitis enter the blood and reach the bones?

Answer 2

from an infection anywhere in body - spread to bones

can also occur as a result of surgery, particularly when a pin or structural insert is involved

Question 3

What is Vitamin D required for?

Answer 3

absorption of calcium

Question 4

Specific cause of: Lordosis

Answer 4

achondroplasia
obesity
discitis
slipping forward of the vertebrae

Question 5

Signs and Symptoms - Osteoporosis:

Answer 5

Compressions fractures of the vertebrae have several obvious effects.

Back pain - associated with altered vertebrae = pressure on nerves

Kyphosis and scoliosis
accompanying loss of height

spontaneous fractures involving head of femur or pelvis frequent

healing of fractures is slow.

Question 6

Treatment for abnormal curvatures of the spine:

Answer 6

medication for pain relief and inflammation
weight loss
wearing a brace
exercise and physical therapy
surgery
various nontraditional forms tx, e.hg. chiropractic, nutritional therapy, acupuncture

Question 7

What are ther goals of Tx in Paget’s disease?

Answer 7

reduce the risk of fractures and deformity

Question 8

What are two common causes of the three types of abnormal spine curvature?

Answer 8

Osteoporosis
Arthritis
but other causes are specific to individual spine curvature disorders, these abnormalities can develop during adolescence

Question 9

Therapeutic measures for Osteoporosis:

Answer 9

Calcium and VitD

Fluoride Supplements - promote bone deposition

Bisphosphonates e.g. alendronate (Fopdsomax) short-term option inhibit osteoclast activity and bone resorption

Calcitonin (miacalcin nasal spray)
Injected human parathyroid hormone to decrease bone reabsorption (helpful for some individuals)

Regular weight-bearing exercise program such as walking or weight-lifting

Raloxifene (Evista) or tamoxifen, classed as a selective oestrogen receptor modulator drugs; recommended specific cases as there is less effect on uterine and breast tissue (use of oestrogen replacement therapy for osteoporosis questioned due to risk cancer)

Surgery to reduce kyphosis and realign the vertebral column

Question 10

What other diseases can Paget’s disease cause?

Answer 10

cardiovascular disease and heart failure

Question 11

Scoliosis

Answer 11

either S-C shaped sideways curve to the spine

Question 12

Signs and Symptoms of Osteomyelitis:

Answer 12

as with any infection, be local and systemic manifestations

local inflammation and bone pain
fever and excessive sweating
chills
general malaise

Question 13

What fractures are common in Paget’s disease?

Answer 13

Pathologic

Question 14

What is Paget’s disease also known as?

Answer 14

Osteitis Deformans

Question 15

What is secondary osteoporosis?

Answer 15

follows specific primary disorder e.g. Cushing syndrome

Question 16

What does “Renal Rickets” refer to?

Answer 16

osteomalacia associated with severe renal disease

Question 17

What is Osteomyelitis?

Answer 17

bone infection usually caused by bacteria and sometimes fungi

Question 18

Specific cause of: Scoliosis

Answer 18

specific cause or most common form - unknown

however tends run in families and some general causes e.g. disease, trauma, congenital defecets beleived to be implicatd

Question 19

What is Osteoporosis characterised by?

Answer 19

decreased bone mass, density

with loss of bone matrix and mineralisation

Question 20

Difference between Osteomalacia and Rickets?

Answer 20

Adults - osteomalacia

Children - rickets

Question 21

What does a lack of calcification of cartilage forming at the epiphyseal plate lead to?

Answer 21

weak bones
deformities
typical “bow legs” (rickets)
the child’s height is usually below normal

Question 22

What may happen when abnormalities to the curvature of the spine occur?

Answer 22

curves misaligned or exaggerated = three main curvature disorders

Question 23

What results if Paget’s disease has affected the Skull?

Answer 23

signs of increased pressure e.g. headache, compression of cranial nerves

Question 24

Tx - Osteoporosis:

Answer 24

Usually, bone cannot be restored to normal structural levels, but therapy can retard further bone loss. In addition to treating any underlying problem, therapeutic may be used.

Question 25

What can a deficit of Vit D and phosphates required for bone mineralisation result in for children?

Answer 25

soft bones | rickets

Question 26

Kyphosis

Answer 26

'hunchback', 'humpback' | abnormally rounded upper back

Question 27

Specific cause of: Kyphosis

Answer 27

``` poor posture spina bifida congenital defects spinal tumours or infections Scheuermann disease ```

Question 28

What is Osteomalacia?

Answer 28

occurs in adults poor absorption of Vit D or sometimes calcium causes: soft bones resulting in compression fractures

Question 29

What is primary osteoporosis?

Answer 29

postmenopausal, senile, idiopathic osteoporosis

Question 30

What are the two forms of Osteoporosis?

Answer 30

primary | secondary

Question 31

True or False? | In some cases is Paget's disease asymptomatic.

Answer 31

True

Question 32

Predisposing Factors for Osteoporosis:

Answer 32

Ageing Decreased mobility/ Sedentary lifestyle Hormonal Factors e.g. hyperparathyroidism, Cushing syndrome, continued intake catabolic glucocorticoids e.g. prednisone Deficits calcium, vitD, protein diet/ Hx deficits - childhood or malabsorption disorders Cigarette smoking Small light bone structure - asian, caucasian excessive caffeine intake

Question 33

What Osteoporosis?

Answer 33

common metabolic bone disorder

Question 34

What is the purpose of the curves formed by the vertebrae?

Answer 34

help spine sbsorb stress of movement and action of gravity

Question 35

Pathophysiology Osteoporosis:

Answer 35

during the continuous bone remodelling process bone resorption exceeds bone formation = thin, fragile bones that are subject to spontaneous fracture, esp vertebrae although bone density and mass reduced, remaining bones are normal osteoporosis affects the bones consisting of higher proportions of cancellous bone, e.g. vertebrae and femoral neck

Question 36

Lordosis

Answer 36

'swayback' | spine curves significantly inward at the back

Question 37

What is seen on X-rays of those with Paget's disease?

Answer 37

structural abnormalities | enlargement (or thickening) apparent in long bones, vertebrae, pelvis and skull

Question 38

Dx Osteoporosis:

Answer 38

bone density scans | x-rays to demonstrate bone change

Question 39

What new methods of treatment are being researched for Osteoporosis?

Answer 39

New methods to stabilise bones and prevent fractures

Question 40

At what age does bone mass generally peak?

Answer 40

young adults then gradually decline depending on genetic factors (Vit D receptors) nutrition weight-bearing activity hormonal levels calcium intake as a child and young adult - critical to the maintenance of bone mass later in life

Question 41

What is Paget's disease?

Answer 41

progressive bone disease older than 40 years excessive bone destruction occurs with replacement of bone by fibrous and abnormal bone

Question 42

What do the conditions Rickets and Osteomalacia result from?

Answer 42

a deficit of Vit D and phosphates required for bone mineralisation ``` occurs with dietary deficits malabsorption prolonged intake of phenobarbital (for seizures) lack of sun exposure ```

Question 43

Why is Decreased mobility/ Sedentary lifestyle a predisposing factor of Osteoporosis?

Answer 43

mechanical stress on bone by muscle activity is essential for osteoblastic activity decreased mobility is a factor with ageing, but it can also occur if a patient is on bed rest one limb or area of the body may be affected by osteoporosis when it is immobilised because of conditions such as a fracture

Question 44

What is the cause of Paget's disease?

Answer 44

cause not yet est, but childhood infection with virus implicated and evidence of genetic factoprs

Question 45

What is Rickets?

Answer 45

Rickets - affects bone development in children | causes bone pain, poor growth and soft, weak bones that can lead to bone deformities

Question 46

What results if Paget's disease has affected the vertebrae?

Answer 46

compression fractures | kyphosis

Question 47

Why is Age a predisposing factor of Osteoporosis?

Answer 47

osteoporosis is common in older individuals, esp postmenopausal women with estrogen deficiency osteoblastic activity is less effective with advancing age

Question 48

Treatment of Osteomyelitis:

Answer 48

antibiotics infection prolonged, significant damage bone - surgery remove, repair damage tissue if insert or mechanical implant involved - surgery to remove the device