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Endo > Metabolic bone disorders (Oktaei) > Flashcards

Metabolic bone disorders (Oktaei) Flashcards

1
Q

bone disorder caused by excess PTH

A

osteoitis fibrosa cystica

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2
Q

bone disorder caused by increased turnover

A

paget

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3
Q

bone disorder caused by formation < resorption

A

osteoprorsis = dec bone density

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4
Q

nml Ca, PO4, and bone density but the bones are still fragile is due to

A

matrix protein problem

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5
Q

a skeletal disorder is characterized by …

A

↑ risk of fracture

↓ bone strength

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6
Q

bone strength is determined by 2 main features

A

bone density and bone quality

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7
Q

WHat are the 4 important risk factors for fracture

A

↑age
female
↓ bone mineral density
↓ BMI > ↑BMI

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8
Q

What are lifestyle risk factors for osteoporosis?

A

alcohol and smoking
↓ physical activity
excessive thinness
high salt intake

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9
Q

are underweight or overweight pts more at risk for fractures

A

underweight

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10
Q

What nutritional factors are risk factors for osteoporosis

A

↓ Ca and Vit D

↑ Vit A

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11
Q

What hormone abnormalities increase risk for osteoporosis

A

excess:
PTH, cortisol, TH

low:
testosterone, androgens, estrogens, cortisol?, catecholamines? (says adrenal insufficiency)

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12
Q

↓ or ↑ PRL increases risk for osteoporosis. WHy

A

↑ bc it inhibits pulsatile secretion of estrogen → ↓estrogen → osteoporosis

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13
Q

In general, disorders affecting _____ part of the intestine increases the risk for osteoporosis. Why?

A

proximal bc that is where Ca is abs

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14
Q

What are examples of GI disorders that increase a person’s risk of osteoporosis

A 
Celiac Disease
Gastric Bypass
Inflammatory Bowel Disease
Malabsorption
Pancreatic disease
Primary biliary cirrhosis
GI surgery
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15
Q

What are the 2 main inherited/genetic dzes that increase a person’s risk for osteoporosis. and then name some others

A

hemahromatosis
Marfan syndrome

Cystic fibrosis
Ehler-Danlos
Gaucher’s disease
Glycogen storage disease
Homocystinuria
Hypophosphatasis
Idiopathic hypercalciuria
Menkes Steely Hair syndrome
Osteogenesis Impefecta
Porphyria
Riley-Day syndrome
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16
Q

Heme disorders assc with osteoporosis

A 
multiple myleoma 
monoclonal gammopathies
leukemia
lymphomas
hemophilia
thalassemia
Sickle cell dz
systemeic mastocytosis
17
Q

Why are rheum disorders assc with osteoporosis

A

treatment is glucocorticoid steroids

ankylosing spondylitis, SLE, RA

18
Q

Why are CNS disorders assc with osteoporosis

A 
decreased physical activity
Epilepsy
Multiple sclerosis
Parkinson disease
Spinal cord injury
Stroke
19
Q

Why is end stage renal dz assc with osteoporosis

A

phosphorus retention → secondary hyperparathyroidism → ↑bone resorption

20
Q

What meds are assc with development of osteoporosis

A

Lauren Poops (in a ) CACA BAG (sorry, lauren)

Lithium
Proton Pump Inhibitors 
Chemo
antacids
Cyclosporine
Anti-convulsants
Barbituates
Anti-coag
Glucocorticoids
21
Q

lab result that is increases suspicion of celiac’s

A

anti-transaminases Abs

22
Q

What does a nml serum Ca with a high urine Ca tell you?

A

low Ca intake , the body compensated → inc PTH → inc release of Ca and PO4 from bone → Sr Ca is normal but bones are getting thinner and thinner

23
Q

DEXA bone scan Z vs T score

A

DEXA Z score:
Bone density as compared to age, sex, ethnicity matched reference population

T score:
Bone density as compared to a young adult reference population.

24
Q

What are the indications for done density testing:

A
  1. W > 65 yrs and Men > 70 yrs
    • clinical risk factors, younger postmenopausal women and M 50-69 yrs
  3. any adult with fracture after 50
  4. adults with a condition or taking meds assc with low bone mass
25
Q

T or F: Any low trauma even painless vertebral fracture is consistent with a diagnosis of osteoporosis, but a bone density test needs to be performed to make a diagnosis

A

F: Any low trauma even painless vertebral fracture does not need a bone density scan for diagnosis

26
Q

Are most vertebral fractures due to low bone density (symptomatic or asymptotic) when they first occur

A

asymptomatic

27
Q

What are the biochem markers of bone formation?

reabs?>

A

formation:
bone specific alk phos
osteocalcin
aminoterminal pro-peptide of type 1 procollagen

reabs:
Sr C telopeptide
Urinary N-telopeptide

28
Q

calculation of the ten year probability of a hip fracture and then ten years probability of a major osteoporotic fracture

A

FRAX

29
Q

Who is the FRAX intended for?

A

postmemnopausal women and men age 50 and older

30
Q

FRAX is calculated using (what bone)

A

femorl neck bone density

Endo (28 decks)

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