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MSS - MSK Exam 1 > Bone Physiology > Flashcards

Bone Physiology Flashcards

1
Q

hypocalcemia

A

hyperexcitablity

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2
Q

hypercalcemia

A

depressed activity

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3
Q

what triggers as result of low calcium

A

PTH secretion

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4
Q

four functions of PTH

A
  • increased bone resorption
  • increased kidney reabsorption
  • block phosphate reabsorption
  • stimulate conversion 25OH VitD to 1,25OH VitD
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5
Q

why is P excretion help with Ca absorption

A

if their levels rise together
-they will precipitate out

if want calcium up we need P down

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6
Q

role of 1,25OH VitD

A
  • calcium reabsorption of gut
  • stimulate P reabsorption
  • allows mineralzation
  • shuts off its own synthesis (negative feedback)
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7
Q

what happens in a loop

A

absorption and mineralization

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8
Q

where is 25OH Vit D converted to 1,25OH Vit D

A

kidney

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9
Q

insufficient 1,25 Vit D levels lead to what?

A

poor mineralization and impaired calcium absorption

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10
Q

calcitriol

A

1,25OH VitD

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11
Q

calcitonin

A

tumor marker

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12
Q

FGF23 absence?

A

hyper-P and hyper-Ca

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13
Q

markers for bone formation

A

alkaline phosphatase
osteocalcin
procollagen peptides (PINP/PICP)

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14
Q

markers of bone resorption

A

urinary hydroxyproline
NTX/CTX or N-telopeptides/C-telopeptides
pryidinoline
deoxypyridinoline

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15
Q

scurvy

A

Vit C deficinency (ascorbic acid)

  • cannot crosslink collagen
  • fragile bones
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16
Q

bone growth during childhood

A

growth of cartilage > endochondral bone formation

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17
Q

increase in bone width?

A

periosteal apposition

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18
Q

bone modeling

A

net bone formation

-two processes uncoupled

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19
Q

remodeling

A

coupled process where resorption followed by bone formation

no net gain in bone

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20
Q

osteoblast activity

A

lay down collagen and noncollagen proteins

21
Q

mineralization of bone?

A

delayed a few days to allow cross linking

22
Q

released by osteoblasts during bone formation?

A

osteocalcin and alkaline phosphatase

23
Q

signal for osteoclast activity?

A

PTH > osteoblasts > activate osteoclasts

24
Q

calcitonin receptor?

A

inhibitory for osteoclasts

25
Q

PTH on osteoblasts?

A

causes release of M-CSF

-differentiation to osteoclast progenitors of hematopoietic stem cells

26
Q

osteoblast affect on osteoclasts?

A

RANK-L by osteoblasts binds RANK on osteoclasts - triggers activity

27
Q

OPG

A

osteoprotegerin
-inhibits bone resorption of osteoclast

soluble receptor for RANK-L

28
Q

Vitamin D

A

necessary for mineralzation of bone

29
Q

PTH

A

signals osteoblasts to activate osteoclasts (resorption)

30
Q

calcitonin

A

inhibits bone resorption (osteoclasts)

31
Q

hormones increasing bone formation?

A

growth hormone
thyroid hormone
insulin
gonadal hormones

32
Q

hormones increasing bone resorption?

A

glucocorticoids

  • suppress GI absorption
  • induce osteoclastogenesis
  • deplete osteoblasts
33
Q

prostaglandins

A

stimulate bone resorption

34
Q

DEXA scan and T scores?

A

can measure bone density

> -1 normal
-1 to -2.5 osteopenia
<-2.5 osteoporosis

35
Q

bone biopsy

A

give architectural structure

36
Q

risk factors for osteoporosis?

  • modifiable
  • nonmodifiable
A

modifiable

  • age
  • race
  • gender
  • menopause
  • build
  • family Hx

nonmodifiable

  • Ca intake
  • Vit D intake
  • estrogen deficiency
  • sedentary
  • smoking
  • alcohol
  • caffeine
  • meds
37
Q

two drugs for osteoporosis?

A

antiresorptive and anabolic

38
Q

antiresorptive drugs?

A

bisphosphonates

39
Q

anabolic drugs?

A

intermittent PTH

40
Q

osteomalacia

A

aka rickets

disorders in mineralization
-deficiency in Vit D

41
Q

Pagets disease

A

excessive osteoblast activity

-treatment - bisphosphonates

42
Q

extremely elevated alkaline phosphatase?

A

sclerotic phase of pagets

43
Q

osteogenesis imperfecta

A

brittle bone disease

weakening of bone due to mutations in collagen leading to fractures and deformity

44
Q

OI type I

A

most common
autosomal dominant
-one allele of alpha-1 procollagen is missing

45
Q

OI type II

A

more rare
point mutation of COL1A1
-extreme bone fragility and death

46
Q

osteopetrosis

A

marble bone disease

defective osteoclastic resorption

47
Q

prolia

A

denosumab

monoclonal antibody for RANK-L

blocks bone resorption

48
Q

benefit to combining antiresorptive and anabolic?

A

no

49
Q

how to inhibit bone formation?

A

inhibit bone resorption by using bisphosphonates

MSS - MSK Exam 1 (11 decks)

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