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Year 2 Endocrine > Bones > Flashcards

Bones Flashcards

1
Q

Osteoclast

A

Break bone down

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2
Q

Osteoblast

A

Bone formation

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3
Q

Name some regulating factors of bone density

A

Genetics 70-80%
Body weight- Low BMI is bad
Sex hormones
Diet and Exercise

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4
Q

What causes bone density loss?

A

Sex hormone deficiency e.g menopause
Low BMI
Diet low in Vitamins C and D

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5
Q

Where are the common sites of osteoporotic bone fractures?

A

Neck of the femur
Vertebral body
Distal Radiu
Humeral Neck

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6
Q

What is DXA

A

A scan used to measure bone density

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7
Q

What sites are used in a DXA scan?

A

Lower Lumbar spine

Hip

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8
Q

What is normal in DXA?

A

Bone density within 1 SD of young adults

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9
Q

What scale is used in in deterring whether someone is osteoporotic?

A

Standard deviation SD from the norm of peak bone density

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10
Q

What is classed as Osteopenia?

A

BMD >1 SD below mean but <2.5SD

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11
Q

What is classes as osteoporosis?

A

BMD >2.5 SD below mean

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12
Q

What is classed as severe osteoporosis ?

A

BMD >2,5 SD below mean and a fragility fracture

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13
Q

What are modifiable risk factors for fractures?

A

Alcohol
Weight
Smoking
Physical inactivity

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14
Q

What are non modifiable risk factors for fractures?

A

Gender and menopause

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15
Q

What are secondary causes of fragility fractures?

A

Hypothyroidism
Coeliac disease
IBD
Cushings

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16
Q

What is the lifestyle advice given to those at risk of fractures?

A

High intensity strength training
Low impact weight bearing
Avoid excess alcohol and smoking
Fall prevention

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17
Q

What dietary supplements should be taken by those at risk of fractures?

A

700Mg calcium

1000Mg post menopausal

18
Q

What treatment should be started on menopausal women before 45 years of age?

A

HRT

19
Q

When is testosterone replacement used?

A

Hypogonadal men

20
Q

How do bisphosphonates work?

A

Taken up by osteoclasts and cause cell death, resulting in reduced bone breakdown
Reduce risk of fractures at all sites

21
Q

Name a bisphosphonate

A

Alendronate

Risendronate

22
Q

What is the main risk with bisphosphonates?

A

Osteonecrosis of the Jaw

23
Q

What other bisphosphanate can be used?

A

Zoledronic acid - IV infusion once yearly

24
Q

What is Denosumab?

A

Monoclonal antibody for RANKL

25
Q

What is the function of RANKL in osteoclasts?

A

Prevents activation of RANK which inhibits osteoclast activation

26
Q

What is the monoclonal antibody used in osteoporosis?

A

Denosumab

27
Q

What is the effect of Corticosteroids on bone?

A

Reduction of osteoblast activity and lifespan
Suppression of osteoblast precursor
Reduction of Ca2+ absorption

28
Q

What is usual age of Pagets?

A

<40 increased incidence in age

29
Q

What is the cause of Pagets?

A

Environmental trigger in a genetically predisposed individual

30
Q

Where does pages affect?

A

Long Bones
Pelvis
Lumbar spine
Skull

31
Q

Pagets Presentation

A

Bone Pain and deformity
Deafness
Compression neuropathies
Raised alkaline phosphates

32
Q

What scan shows the distribution of Pagets?

A

Isotope scan

33
Q

Treatments in Pagets?

A

Analgesics and Bisphosphonates

34
Q

What is pathology of Pagets?

A

Abnormal osteoclast activity followed by abnormal osteoblast activity resulting in abnormal bone
-reduced strength and increased fracture risk

35
Q

What is Osteogenesis imperfecta?

A

Rare group of genetic disorders of Type 1 Collagen

36
Q

What genes are affected?

A

COLIA1 and COLIA2I

37
Q

What is osteogenesis imperfecta type 1?

A

Mild

38
Q

What is osteogenesis imperfecta type 2?

A

Presents in neonates

Incompatible with life

39
Q

What is osteogenesis imperfecta type 3 and 4

A

Very severe

40
Q

What is the treatment in osteogenesis imperfecta?

A

No cure
Fracture fixation
Consider bisphosphonates

41
Q

In a young child presenting with fractures what should always be considered?

A

Non accidental injury

42
Q

What mode of inheritance is osteogenesis imperfecta?

A

Autosomal dominant

Year 2 Endocrine (21 decks)

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