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Endocrine 2020 > Endocrine Bone Problems > Flashcards

Endocrine Bone Problems Flashcards

1
Q

what endocrine disorders can cause osteoporosis?

A

hyperthyroidism
hyperparathyroidism
Cushing’s

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2
Q

diagnosis of OP

A

DEXA scan

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3
Q

what is the T score on a DEXA scan?

A

difference between patient and that of a young healthy adult

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4
Q

what is the Z score on a DEXA scan?

A

difference between patient and someone of the same age

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5
Q

classification from a DEXA scan

A
  • Normal: BMD within 1 SD of the young adult reference mean
  • Osteopenia (low mass): BMD >1SD of young adult mean but <2.5 SD below this value
  • Osteoporosis: BMD of 2.5 or more SD below the young adult mean
  • Severe osteoporosis: BMD of 2.5 of more SD below with fragility fracture
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6
Q

conservative management of OP

A

strength training
lifestyle (alcohol, drugs)
fall prevention

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7
Q

pharmacological options in OP

A 
calcium and vitamin D
bisphosphonates
zoledronic acid
denosumab
teriparatide
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8
Q

what do bisphosphonates do?

A

they are ingested by osteoclasts causing death

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9
Q

adverse of bisphosphonates

A

osteonecrosis of jaw and oesophageal calcification

consider bone holiday

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10
Q

example of bisphosphonates

A

aldendronate

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11
Q

how is zoledronic acid given?

A

once yearly infusion for 3 years

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12
Q

what is denosumab?

A

monoclonal Ab that inhibits osteoclasts

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13
Q

what is teriparatide?

A

PTH that stimulates bone growth (anabolic agent)

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14
Q

what causes Paget’s disease?

A

environmental trigger in genetically predisposed individual

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15
Q

what is Paget’s disease?

A

abnormal osteoclast activity with increased osteoblast activity leading to abnormal bone structure

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16
Q

presentation of Paget’s disease

A 
bone pain
deformity
increased CO (bone vascularity increases)
large limb volume
deafness (bony meatus compression)
compression neuropathies
17
Q

diagnosis of Paget’s disease

A

XR
isotope bone scan
high ALP

18
Q

management of Paget’s disease

A

bisphosphonates if pain not responding to analgesia

19
Q

what is osteogenesis imperfecta?

A

AD mutations in type 1 collagen genes

20
Q

what is osteogenesis imperfecta associated with?

A

blue sclerae

dentinogenesis imperfecta

21
Q

management of osteogenesis imperfecta

A

fracture fixation
bisphosphonates
surgery to correct deformity

no cure, differential for NAI

Endocrine 2020 (35 decks)

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