Cla Flashcards

1
Q

What do osteoclast do?

A

Break down bone to release calcium

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2
Q

Symptoms of acute hypercalcaemia

A

Thirst
Dehydration
Confusion
Polyuria

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3
Q

Symptoms of chronic hypercalcaemia

A

Myopathy
Osteopenia 4Fractures
Depression
Abdo pain (pancreatitis, ulders, renal stones)

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4
Q

Management of hypercalcaemia

A

Fluids
Loop diuretic (once rehydrated)
Bisphosphonats
Seroids ocasionally used

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5
Q

Causes of hypercalcaemia

A
Primary hyperparathyroidism 
Malignancy 
Drugs (Vit D, thiazides) 
Granulomatous disease 
FHH
High bone turnover( Paget's)
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6
Q

Symptoms of hypocalcaemia

A
Paraesthesia 
Muscle cramps/tetany 
Muscle weakness, fatigue 
Broncho/laryngospasm 
Fits
Chovstek's sign (tapping over CN VII)
Trosseau sign (wrist very flexed)
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7
Q

Findings of hypocalcaemia on ECG

A

QT prolongation

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8
Q

Causes f hpocalcaemia

A

Hypoparathyroid
Vit D deficiency
Chronic renal failure

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9
Q

Managemnt of acute hypocalcaemia

A

1ml 10% IV calcium gluconate

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10
Q

Long term management of hypocalcaemia

A

Vit D & calcium supplements

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11
Q

Is there calcium present in the urine in FHH?

A

No

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12
Q

Pathogenesis of osteoporosis

A

Increase in bone resorption over formation

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13
Q

Using Qfracture, at which point should a patient be referred for DEXA?

A

If > 10%

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14
Q

How is a DEXA scan interpreted?

A
Normal = within 1 SD of mean 
Osteopenia = 1-2.5 SD below mean
Osteoporosis = >2.5 DF below mean
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15
Q

Secondary endocrine causes of osteoporosis

A

Hyperthyroidism
Hyperparathyroidism
Cushings

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16
Q

Secondary GI causes of osteoporosis

A

Coeliac disease
IBD4Chronic liver disease
Chronic pancreatitis

17
Q

What lifestyle modifications can help with osteoporosis?

A
HIT training 
Avoid excess alcohol 
Weight loss 
Stop smoking 
Fall prevention 
Diet
18
Q

What are the drug treatment options for osteoporosis?

A
Calcium + Vit D 
Bisphosphonates
Zoledronic acid 
Denosumab 
Strontium ranelate
Teridaratide
19
Q

Mechanism of action of bisphosphonates

A

Ingested by osteoclasts leading to cell death

20
Q

Side effects of bisphosphonates

A

Necrosis of jaw
Oesophageal cancer
Atypical fractures

21
Q

What is the second line drug management of osteoporosis if intolerant of bisphosphonates

A

Zoledronic acid

22
Q

Mechanism of action of denosumab

A

Monocloncal antibody specific to RANKL ihibits development of oseoclasts

23
Q

Side effects of denosumab

A

Hypocalcaemia
Eczema
Cellulitis

24
Q

When should strontium ranelate not be used?

A

Vascular disease