Calcium PTH

Question 1

Osteoporosis

Answer 1

low bone mass

RIsk - thin, post meonopausal women, caucasia , asian

Smoking, age, excessive caffeine, alcohol intake, hisory of estorgne depletion, amenorhea, eating disorder ect. corticosteroid use - all increase risk

Hist/exa,

• fractures w minimal trauma
• loss of height
• throacic kyphosis

Diagnoses

• DEXA scan
• (women >65, men >70 - or younger if other risk factors)
• Diagnosis - bone mineral density 2.5 dstandard deviation sless than a young person (T-score)
• osteopaenia is between 1-2.5 standard deviaitons

Lab values - normal calcium, phosphate, pth
Xray - demineralisaiton only apaprent after >30% bone density lost

Treamtent
-Prevention - caclium + vit D
-smokinge cesation, weight bearing exercsie
Bisphosphonates - zoneldronic acid, alendronate (not used in osteopaenia)

Complciations - fracture

Question 2

Pagents disease

Answer 2

too much bone remodeling

• excessive bone reposition, and growth
• leads to skeletal deformities and fractures

Cause

• unclear
• can be triggered by viral infections e.g measels
• and linked to certain genetic mutations

Can affect one bone or multiple

• skull
• lumbar vertebrae
• pelvis
• femur

Early on - no symptoms
Misshapen bone
-imagine on nerves - pain
-overgrown - lion face, hearing loss, vision loss

-bone cancer increased risk - pagents sarcoma
-kyphosis
pelvic asymmetry - bowlegs

-arthritis or joint inflammation

Diagnosis

• ALP
• Xray - lytic lesions or thickened bone cortices
• Bone biopsy - exclude malignancies

-associated with hyperparathyrodism and increased risk of sacrovma