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MRCP Master > Endocrine Bone > Flashcards

Endocrine Bone Flashcards

1
Q

DX: Low serum calcium, low serum phosphate, raised ALP and raised PTH

A

osteomalacia

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2
Q

Dx: Hypercalcaemia, renal failure, high total protein

A

Multiple myloma

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3
Q

Dx: calcium, phosphate and ALP are normal

A

Osteopetrosis

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4
Q

Cinacalcet used in

A

primary hyperparathyroidism not fit for surgery
is a calcimimetic - a drug that ‘mimics’ the action of calcium on tissue by allosteric activation of the calcium-sensing receptor

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5
Q
A
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6
Q

Rx. severe hypocalcaemia (e.g. carpopedal spasm, tetany, seizures or prolonged QT interval)

A

IV calcium gluconate, 10ml of 10% solution over 10 minutes
ECG monitoring is recommended

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7
Q

What ALP an indicator of?

A

Bone metabolism and liver fx

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8
Q

High ALP

A

Bone - pagets
Liver : blk of bile ducts, cirrhosis, hepatitis, mono
Pregnancy

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9
Q

Why do bone cell secrete alp

A

Format need alkaline environment

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10
Q

What effect does PTH have on bone

A

Low levels Promotes bone formation
PTH regulates osteoclast maturation
High level = bone breakdown

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11
Q

PTH effects 3

A

Bone reabsorption
Increases ca2+
Decrease phosphate levels by urinary excretion

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12
Q

Factors that increase bone mass loss and increase chance of osteoporosis?

A

Low Estrogen
Hypo calcium
Genetics
Drugs heparin, thyoxine antconvulants
Low weight

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13
Q

Effect of estrogen on bone

A

Increase osteoblasts activity
Decreases osteoclast activity

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14
Q

What are bisphospjonates

A
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15
Q

What is Teriparatide ?

A

Recombinant parathyroid hormone
But actually active osteoBLASTs more than clasts

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16
Q

MOA hydrochlorothiazide in osteoporosis?

A

Promote ca retention in the distal convoluted tubule
Osteoblasts differ

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17
Q

Se of thiazides

A
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18
Q

MOA Denosmab

A

Inhibits osteoclasts maturation
Monoclonal antibody against rank-L

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19
Q

MOA Raloxifene

A

SERM - mimics estrogen = decreased risk of breast ca

20
Q

MOA calcitonin

A

Decrease bone resorption

21
Q

What is happens to bone in osteopetrosis?

A

Abnormally dense bone
Acid environment isnt there for resorption of old bone

22
Q

Sx of osteopetrosis?

A
23
Q

Radiological dx of osteopetrosis (2)

A
24
Q

osteopetrosis labs

A

Thrombocytopenia
Reduced ca2+
Increased ALT

25
Q

Rx osteopetrosis

A

None in adults

26
Q

What is paget disease of the bone & causes

A

Abnormal bone remodeling esp. skull, lumbar & femurs

Genetic and infection

27
Q

Stages of pagets 4

A
28
Q

Sx of pagets

A
29
Q

Skeleton sx of pagets

A

May lead to av shut leading to cardiac failure

30
Q

Paget lab and radiology

A
31
Q

Rx paget

A

Bisphosates

32
Q

What is osteomalacia?

A

Deficiency in ca, vitd, phosphate
= inadequate bone mineralisation

33
Q

Triggers of vit d deficiency

A

Liver and kidney failure

34
Q

Liver failure and vit d

A

25 hyroxy is lacking

35
Q

Kidney failure and vit d

A

25 hydroxy lacking

36
Q

What happens with to parathyroid with vit d

A

Hyper parathyroidism

37
Q

Labs in osteomalacia

A

High ALT
Low ca2+ (May lead to high PTH & low serum phosphate )
Low vit d

38
Q

Radiology of osteomalacia

A
39
Q

Rx osteomalacia

A

Vit d

40
Q

4 bone disorders

A

Osteoporosis
Osteopetrosis
Peget
Osteomalacia

41
Q

Medication Causes of of HYPERca2

A

Lithium
Thiazides
Vitd
Calcium containing ant acids

42
Q

ECG changes with hyperCa2+

A

Bradycardia, av block, shortened QT

43
Q

Fx of PTH 3

A
44
Q

Causes and labs in primary hyper calcium

A

Tumour
Pth high ca2+ high

45
Q

Causes of 2ndary hyper parathyroid

A

Low Vit d or CKD
Pth high
LOW ca or normal

46
Q

Cause of tertiary hyper parathyroidism

A

Hyperplasia
High PTH
HIGH ca

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