Metabolic bone disease

Question 1

diagnosis of osteoporosis

Answer 1

DEXA - T score >2.5 below expected

NB - 1-2.5 below = osteopenia

Question 2

sympto and signs of osteoporosis

Answer 2

low impact fractures (hip, vertebrae, wrists (colles))

normal Ca/PO4/ALP

Question 3

Xray findings in osteomalacia

Answer 3

looser zones

Question 4

nutrient changes in osteomalacia

Answer 4

N/dec Ca
dec PO4
inc ALP

Question 5

adult sympto of osteomalacia

Answer 5

bone pain/tenderness, proximal muscle weakness

Question 6

sympto of osteomalacia in kids

Answer 6

(rickets) -> bone pain, bowing tibia, pigeon chest, delayed walking

Question 7

lesions in pagets

Answer 7

mixed lytic/sclerotic lesions

Question 8

x ray findings in pagets disease

Answer 8

cotton wool skull, picture frame/ivory vertebrae, lucency of pelvis

Question 9

Histo findings in Pagets

Answer 9

huge osteoclasts (>1000 nuclei)
mosaic pattern of lamellar bone
Normal Ca/PO4, v inc ALP

Question 10

sympto of Pagets

Answer 10

hot area over bone pain, inc head size, inc CO, deafness

Question 11

bone changes in pri hyperparathyroidism

Answer 11

inc PTH, -> inc Ca reabs, inc PO4 excretion -> osteitis fibrosis cystica

Question 12

x ray findings in pri Hyperpara

Answer 12

browns tumours (marrow fibrosis + cysts)
salt and pepper skull
bone resorption in phalanges