Disorders of the Skeletal System : Metabolic and Rhuematic Disorders Flashcards
What is Osteoporosis?
a metabolic bone disorder
characterized by a decrease in bone mass and density, combined with loss of bone matrix and mineralization
What may be the first indicator of osteoporosis?
bone fracture
What is the patho behind Osteoporosis?
bone reabsorption exceeds bone formation
remaining bone is normal
Who is osteoporosis usually seen in?
post menopausal women (b/c lack of estrogen)
short women more than tall women
thinner women more than thicker women
Why don’t we just give estrogen to post menopausal women?
because estrogen has been linked to cancer
What are the predisposing factors for Osteoporosis?
smoking
calcium deficit
sedentary lifestyle
aging
Osteopenia
Hormonal Factors (Hyperparathyroidism or Cushing’s Syndrome)
Long Term intake of glucorticoids (steroids) such as Prednisone
What is osteopenia?
mineral bone density lower than normal but not osteoporosis
can contribute to the pathology of all metabolic bone diseases
mostly diagnosed after a bone fracture
When does bone density peak?
30 years old
Which race is at a higher risk of Osteoporosis?
European and Asian have higher risk
If your mother had osteoporosis are you at a greater risk to develop osteoporosis in your lifetime?
yes, at up to an 80% increase in likelihood
What are the modifiable risk factors for osteoporosis?
excessive alcohol, Vitamin D deficiency (calcium carrier), tobacco smoking, malnutrition, underweight, inactivity
How does tobacco increase the risk of osteoporosis?
tobacco smoking increases the breakdown of estrogen(look like a man)
What is Osteomalacia?
defective mineralization of bone WITHOUT the LOSS of bone matrix
What are the two causes of Osteomalacia?
inadequate calcium
inadequate phosphate
Osteomalacia is highly seen among…
the elderly
Can Osteomalacia be treated?
can be treated with diet if that is the cause
What is a matrix?
intracellular substance of tissue/s from which a structure develops
Children with what disease are at risk for Osteomalacia?
Rickets
What is Rickets?
Failure or delay in calcification of the growth plate
seen in children
several forms
may be nutritional: Vitamin D dependent or Vitamin D resistant
What is Rickets generally caused by?
Vitamin D deficiency
Premature Osteoporosis is being seen in who?
female athletes (they don’t menstruate)
What is Paget’s Disease?
Chronic
significant bone reabsorption followed by hectic bone reformation
bones are irregular and fracture easily
bones tend to bow or take abnormal shapes
Clinical features are going to vary depending on the extent of the disease
What are the commonly affected areas with Paget’s Disease?
pelvis, femur, lower lumbar vertebrae
*this differentiates this disease from osteoporosis
What is Rheumatoid Arthritis (RA)?
autoimmune disorder causing chronic systemic inflammatory disease
can effect tissue or organs but primarily flexible synovial joints
major cause of disability, can cause loss of function
Remissions and exacerbations
Severity varies from mild to severe, reflecting the number of joints involved (polyarticular)
often larger joints but can be in smaller joints
What does Polyarticular mean?
involving many joints
RA has a higher incidence in who?
women than men
Discuss the development of RA
1) ABNORMAL IMMUNE RESPONSE, causing inflammation of the synovial membrane with vasodilation, increase permeability, and formation of exudates, causing the typical red, swollen, and painful joint
2) Rheumatoid Factor (antibody against immunoglobin G) is present in the majority of patients with RA
3) After the FIRST period of acute inflammation (in capsule around joints in the synovium), the joint MAY RECOVER COMPLETELY….. but….
* During subsequent EXACERBATIONS the process will CONTINUE into……….
- Synovitis
- Pannus Formation
- Cartilage Erosion
- Fibrosis
- Ankylosis
Define Pannus
fibrous tissue in synovium
Define Fusion
when you cant move a joint
What is Ankylosis?
fusion
Define exacerbations?
flare ups