Metabolic Diseases Flashcards

1
Q

give example of a qualitative and quantitative bone defect

A

qualitative: osteomalacia
quantitative: osteoporosis

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2
Q

what is the pathology of osteomalacia

A

softer bones due to decreased osteoid mineralisation

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3
Q

risk factors for osteomalacia

A

vit d deficiency, phosphorus deficiency, calcium deficiency,
alcohol, CKD, refeeding synd

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4
Q

what is seen on examination in osteomalacia

A

small bone deformities, bow leg, square head, pigeon chest

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5
Q

presentation of hypocalcaemia

A

cramps, paraesthesia, fatigue, seizure, brittle nail

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6
Q

symptoms of osteomalacia

A

bone pain, pathological fractures, hypocalcaemia symptoms

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7
Q

investigations of osteomalacia

A

xr,

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8
Q

what is seen on x-ray in osteomalacia

A

pseudofractures; Looser’s zones

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9
Q

management of osteomalacia

A

vit D, Ca & phosphate supplements

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10
Q

what is rickets

A

osteomalacia in children

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11
Q

risk factors for osteoporosis

A

CCS, malnutrition, CKD, cancer, Cushing’s, hyper/hyperparathyroidism,

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12
Q

pathology of osteoporosis

A

bone mineral density < 2.5

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13
Q

investigations for osteoporosis

A

DEXA scan, normal serum Ca & phos

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14
Q

what is type 1 osteoporosis

A

post-menopause

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15
Q

what is type 2 osteoporosis

A

old age related

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16
Q

what type of osteoporosis is more likely in hip fractures

A

type 2

17
Q

what type of osteoporosis is more likely in colles fracture

A

type 1

18
Q

management optics of osteoporosis

A

calcium and vit d supplements, biphosphonate, +- desunomab, +- strontium, +- HRT

19
Q

example, mechanism and side effects of biphosphonates

A

alendronate,

20
Q

mechanism of desunomab

A

decreases osteoclast activites

21
Q

mechanism of strontium

A

increases osteoblast activity

22
Q

why can osteoporosis occur post menopause

A

< protective oestrogen

23
Q

what does a DEXA scan measure

A

bone mineral density

24
Q

pathology of paget’s disease

A

increased bone turnover, increases osteoblasts and osteoclasts, thick/brittle bone layed

25
Q

which bone are commonly affected by paget’s disease

A

axial skeleton, femur, tibia

26
Q

presentation of paget’s disease

A

asymptomatic, elderly, pain, bony deformity, pathological fractures

27
Q

complications of paget’s disease

A

osteoarthritis, hypercalcaemia, nerve compression, osteosarcoma, high output heart failure

28
Q

what clinical sign can be seen in paget’s disease of the tibia

A

saber tibia

29
Q

investigations for paget’s disease

A

> ALP, normal Ca, normal phosphorus, XR, bone scan

30
Q

what is seen on xr in paget’s disease

A

thick trabeculae, lysis+ sclerosis

31
Q

management of paget’s disease

A

analgesia, bisphosphonates, calcitonin, +- joint replacement

32
Q

cause of primary hyperparathyroidism

A

adenoma, hyperplasia, malignancy of parathyroid

33
Q

cause of secondary hyperparathyroidism

A

hypocalcaemia from < vit D or CKD

34
Q

cause of tertiary hyperparathyroidism

A

parathyriod hyperplasia after prolonged secondary hyperparathyroidism

35
Q

presentation of hyperparathyroidism

A

fatigue, depression, bone pain, myalgia, kidney, osteoporosis

36
Q

is phosphate normal in primary hyperparathyroidism

A

yes