Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

SM Endocrine > Disorders of Bone Health including Osteoporosis > Flashcards

Disorders of Bone Health including Osteoporosis Flashcards

1
Q

What is osteoporosis

A

Progressive systemic skeletal disease characterised by low bone mass and microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How common is osteoporosis

A

One in two women
one in six men
All over the age of 50 will develop osteoporosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Where are the common fracture sites for osteoporosis

A

Neck of femur
Vertebral body
Distal radius
Humeral neck

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How much of the adult skeleton is remodelled each year

A

10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does osteoporotic bone look like

A

Loss of bone

large spaces and breaks in the microscopic architecture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What contributes to peak bone mass

A 
Genetics 
Body weight 
sex hormones
diet
exercise
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What contributes to bone loss

A 
Sex hormone deficiency 
Body weight 
Genetics
Diet
Immobility 
Diseases
Drugs. e.g. steroids, aromatase inhibitors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the modifiable factors for reducing the risk of fragility fractures

A 
BMD 
Alcohol
weight
smoking 
physical inactivity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the non-modifiable factors or reducing the risk of fragility fractures

A 
Age 
gender
ethnicity
preious fracutre
family history 
early menopause (
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is involved in the WHO fracture risk calculator

A

Allows calculation of absolute risk for incorporating additional risk factors rather than just BMD
Prediction of 10 year fracture risk of major osteoporotic fracture or hip fracture
Some limitations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are some of the pros of FRAX

A

Freely available

calculates 10 year absolute risk of hip or major OP fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are some of the cons of FRAX

A

Underestimates vertebral fracture risk
Same level of risk assigned to all secondary causes
Dichotomised variable smoking/ alcohol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What can bone mineral density predict

A

risk independently of other risk factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What type of scans are used to measure BMD

A

DEXA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What BMD result diagnoses osteopenia

A

BMD >1 SD below the young adult mean

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What BMD result diagnosis osteoporosis

A

BMD >2.5 SD below the young adult mean

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What BMD result diagnosis severe osteoporosis

A

BMD >2.5 SD below the young adult mean with fragility fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

To assess someone with suspected bone disease, what should we investigate

A 
U&E
LFT
Bone biochemistry 
FBC
PV 
TSH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What other factors should be considered when investigating someone with suspected bone disease

A 
Protein electrophoresis 
Coeliac antibodies
Testosterone
Vitamin D 
PTH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is a endocrine causes of bone disease

A

hyperthyroidism, hyperparathyroidism, Cushing’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are some GI causes of bone disease

A

Coeliac disease
IBD
chronic liver disease
chronic pancreatitis

22
Q

What are some Resp causes of bone disease

A

CF

COPD

23
Q

What are 5 bits of lifestyle advice that are recommended in managing a patient with osteoporosis

A 
High intensity strength training 
Low impact weight bearing exercise 
Avoidance of excess alcohol
Avoid smoking
Fall prevention
24
Q

How much calcium should be taken in from the diet

A

700mg calcium or 1000mg for postmenopausal women

25
Q

What are some non-dairy sources of calcium

A 
Bread and cereals 
fish with bones 
nuts 
green veg
beans
26
Q

What are the drug treatment options for bone disease

A 
calcium and vitamin D supplementation 
bisphosphonates
denosumab
teriparatide 
strontium ranelate 
HRT 
testosterone
27
Q

What are bisphosphonates

A

Antiresorptive agents

28
Q

What do bisphophonates do

A

Prevent bone loss at all sites vulnerable to osteoporosis

Reduce risk of hip and spine fractures

29
Q

Where do bisphosphonates work

A

Ingested by osteoclasts leading to cell death thereby inhibiting bone resorption

30
Q

What are some long term concerns of bisphosphonates

A

Osteonecrosis of the jaw, oesophageal Ca, atypical fractures

31
Q

How is Zoledronic Acid given

A

Once year IV infusion for 3 years

5mg in 100mls NaCl over 15 mins

32
Q

What is the success rate of using Zoledronic acid

A

Around 70% reduction in vertebral fracture and 40% reduction rate in hip fractures

33
Q

How does Denosumab work

A

Targets and binds with high affinity and specificity to RANKL
This prevents activation of its receptor RANK, inhibiting development and activity of osteoclasts, decreasing bone reposition and increasing bone density

34
Q

How is denosumab given

A

SC injection 6 months

35
Q

What is the 3rd line agent for osteoporosis

A

Strontium Ranelate

36
Q

What are the contraindications of Strontium Ranelate

A

History of thromboembolic disease
IHD
peripheral arterial disease
uncontrolled hypertension

37
Q

How does Teriparatide work

A

Recombinant parathyroid hormone

stimulates bone growth rather than reducing bone loss

38
Q

When should treatment be started for those with bone disease

A

When the T score is

39
Q

What are the direct affects of corticosteroids and bone

A

reduction of osteoblast activity and lifespan
suppression of replication of osteoblast precursors
reduction in calcium absorption

40
Q

What are the indirect effects of corticosteroids and bone

A

Inhibition of gonadal and adrenal steroid production

41
Q

Biochemically, how do glucocorticoids affect calcium metabolism

A

Increase PTH and decrease bone mass

42
Q

What is Paget’s disease of bone

A

Abnormal osteoclastic activity followed by increased osteoblastic activity
Abnormal bone structure with reduced strength and increased fracture risk

43
Q

What is the aetiology of Paget’s disease

A

Uncertain
Viral
encironmental
biomechanical trigger in genetically predisposed individual

44
Q

What bones are affected in Paget’s disease

A

long bones, pelvis, lumbar spine and skull

45
Q

How does Paget’s disease present

A

bone pain, deformity (bowed legs) deafness or compression neuropathies

46
Q

What is a rare complication of Paget’s disease

A

osteosarcoma

47
Q

What is used to diagnose Paget’s disease

A

XR
isotope bone scan shows distribution
raised alkaline phosphatase with normal LFT

48
Q

What can be used to treat Paget’s disease

A

Analgesia

if not responding bisphosphonates

49
Q

What type of condition is Osteogenesis Imperfecta

A

Rare group of genetic disorders mainly affecting bone

Autosomal dominant inheritance

50
Q

What might also be seen in osteogenesis imperfecta

A

blue sclerae and dentinogenesis imperfect

51
Q

How do severe forms of osteogenesis imperfecta present

A

Fractures in childhood (could be mistaken for non-accidental injury)

52
Q

What is the treatment for osteogenesis imperfecta

A

no cure - fracture fixation, surgery to correct deformities, bisphosphonates

SM Endocrine (27 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions