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Endocrine > Bone health > Flashcards

Bone health Flashcards

1
Q

what is osteoprosis

A

progressive skeletal disease characterized by low bone mass and deterioration of the bone tissue, with increase in bone fragility and fracture risk

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2
Q

which gender is more common female or male in osteoporosis

A

female

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3
Q

is osteoporosis asymptomatic or has symtoms

A

assymptomatic

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4
Q

where are common fracture sites in the body

A

neck of femur, vertebral body, distal radius, humeral neck

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5
Q

how much of the skeleton is remodeled each year

A

10%

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6
Q

what is normal transitioning between osteoblasts and osteoclasts

A

osteoclast- osteoblast numbers the same, rapid turnover and regeneration

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7
Q

what causes fractures?>

A

BREAKS IN THE INFRASTRUCTURE LEAD TO WEAKNESS CAUSING FRACUTRES

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8
Q

WHEN DO YOU TYPICALLY HAVE PEAK BONE MASS

A

LATE 20S

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9
Q

what factors can lead to bone loss

A

glucocorticoids, diet, weight, sex hormone deficiency, diseases, immobility

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10
Q

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

A

oestrogen deficinecy

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11
Q

what does the fracture risk calculator do?

A

predicts 10 yearr fracture risk of major osteoporotic fractureses

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12
Q

when would you use the risk factor assessment?

A

over 50s, and under 50s that have history with glucocorticoid involvement and early menopause

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13
Q

when shouda DEXA scan be performed?

A

anyone who gets a fracture score of 10% or more

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14
Q

what does DEXA do?

A

measures bone density independently of anything else

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15
Q

what advice should you give for managing osteoporosis

A

high intensity strength training, low impact weight bearing, avoid alcohol, avoid smoking, fall prevention

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16
Q

what should post menopausal women aim for in calcium intake

A

1000mg

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17
Q

what drugs are used in the treatment of osteoporosis

A

calcium and vit D supplements, bisphosphonates, denosumab,, HRT, testosterone

18
Q

what do calcium and vit D reduce the risk of?

A

non vertebral fractures

19
Q

what are the guidelines for taking calcium and vit D supplements

A

cannot take calcium within 2 hours of oral bisphosphonates. If calcium in diet is adequate, vit D may be preferred for OP treatment

20
Q

what are bisphosphonates and what do they do?

A

antiresorptive agents, prevent bone loss at all sites vulnerable to OP, reduce risk of hip and spine fracutre

21
Q

how do bisphosphonates work chemically?

A

ingested by osteoclasts which lead to cell death thus inhibiting bone resorption. Slows bone growth

22
Q

what T score must OP patients have to use bisphosphonates ?

A

less than -2.5

23
Q

how long should bisphosphonates be used

A

5 years

24
Q

how often can patients take Zoledronic acid

A

1 yearly IV infusion for 3 years

25
Q

what is zoledronic

A

a bisphosphonate that can be taken IV

26
Q

what is denosumab

A

monoclonal antibody that targets and binds with high affinity and specificity to RANKL- inhibits development and activity of osteoclasts, decreasing bone resoprtion and density

27
Q

how is denosumab taken?

A

sub cut injections 6 monthly

28
Q

what are some side effects of denosumab

A

hypocalcaemia, eczema, cellulitis

29
Q

when is strontium ranelate used

A

3rd line treatment as fracture reduction risk not as high, contraindicated in thromboembolic disease, peripheral artery disedase, uncontrolled hypertension. DONT USE IF ALTERNATIVE METHOD AVAILABLE

30
Q

what is teriparatide

A

a parathyroid hormone

31
Q

what does teripatide do?

A

stimulates bone growth as opposed to oppresss cell death

32
Q

in what patients would you use teriparatide

A

> 65 with T score of

33
Q

what effects do corticosteroids have on bone

A

reduce osteoblast formation, suppress osteoblast precursors, reduce calcium absorption. Indirectly inhibit gonadal and adrenal steroid production

34
Q

what si pagets disease of bone

A

abnormal osteoclast activity and increased osteoblast activity. bnormal bone structure with reduced strength and increased fracture risk. single or multiple sites.

35
Q

what bones does pagets disease effect

A

long bones- femur, pelvis, lumbar spine, skull

36
Q

what would you present with pagets disease

A

bone pain, deformity, neuropathies, raised ALP,

37
Q

What imaging would you use

A

isotope bone scan, XR ALP raised

38
Q

how would you treat pagets disease

A

bisphosphonates if not responding to analgesia

39
Q

what is osteogenesis imperfecta

A

rare group of genetic disorders affecting bone due to collagen mutation, usually autosomal dominant

40
Q

what can osteogenesis be confused with

A

non accidental injury due to fracture risk as children

Endocrine (23 decks)

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