Metabolic Bone Disease Flashcards
What does vitamin D do?
Stimulates absorption of calcium and phosphate from gut and make them available for bone mineralisation
What is the difference between rickets and osteomalacia?
Rickets is before epiphyseal plates have closed
What causes rickets and osteomalacia?
Severe nutritional Vit D or calcium leads to insufficient mineralisation
What is Paget’s disease of bone
Localised disorder of bone turnover
Increased bone resorption then bone formation
Leads to disordered bone -more susceptible to deformity and fracture
Symptoms of Paget’s of the bone
Patient > 40 with bone pain, occasionally deformity
Excessive heat over paretic bone or by neurological complication such as nerve deafness
Elevated serum alkaline phosphatase
Treatment of Paget’s Disease
Dont treat asymptomatic unless in skull
Do not treat on raised phosphatase alone
IV bisphosphonate therapy
One off IV zoledronic acid
What is osteogenesis imperfecta
Genetic disorder of connective tissue
Characterised by fragile bones from mild trauma and even acts of daily life
Types of OI
8 different types
Type 1 - milder form present when child starts to walk or adults
Type 2 - lethal by age 1
Type 3 - progressive deforming with bone dysplasia and poor growth
Type 4 - similar to 1 but more severe
Signs and symptoms of OI
Growth deficiency Defective tooth formation Hearing loss Blue sclera Scoliosis Barrel chest Ligamentous laxity Easy bruising
Management of OI
Surgery to treat fractures
Medical to prevent fractures (IV bisphos)
Social adaptions educationally and socially
Genetic counselling for parents and next generation
What is osteoporosis
Metabolic bone disease of low bone mass and micro architectural deterioration of bone tissue –> increased fragility and increase in fracture risk
What is risk of fracture related to
Age
BMD
Falls
Bone turnover
Who should be treated in osteoporosis
Those with osteopenia (T score -1 to -2.5) if previous fracture or
Those with osteoporosis (T-score below -2.5)
What is FRAX
WHO fracture risk assessment tool
Doesn’t accomodate all RFs
Depends on adequacy of epidemiological info
What is Q fracture
Men and women 30-85
Multiple variables - CV risks, falls, TCA
Does not have ability to add BMD
Some variables and risks can’t be altered by osteoporotic medications
