Metabolic Diseases Flashcards
give example of a qualitative and quantitative bone defect
qualitative: osteomalacia
quantitative: osteoporosis
what is the pathology of osteomalacia
softer bones due to decreased osteoid mineralisation
risk factors for osteomalacia
vit d deficiency, phosphorus deficiency, calcium deficiency,
alcohol, CKD, refeeding synd
what is seen on examination in osteomalacia
small bone deformities, bow leg, square head, pigeon chest
presentation of hypocalcaemia
cramps, paraesthesia, fatigue, seizure, brittle nail
symptoms of osteomalacia
bone pain, pathological fractures, hypocalcaemia symptoms
investigations of osteomalacia
xr,
what is seen on x-ray in osteomalacia
pseudofractures; Looser’s zones
management of osteomalacia
vit D, Ca & phosphate supplements
what is rickets
osteomalacia in children
risk factors for osteoporosis
CCS, malnutrition, CKD, cancer, Cushing’s, hyper/hyperparathyroidism,
pathology of osteoporosis
bone mineral density < 2.5
investigations for osteoporosis
DEXA scan, normal serum Ca & phos
what is type 1 osteoporosis
post-menopause
what is type 2 osteoporosis
old age related
what type of osteoporosis is more likely in hip fractures
type 2
what type of osteoporosis is more likely in colles fracture
type 1
management optics of osteoporosis
calcium and vit d supplements, biphosphonate, +- desunomab, +- strontium, +- HRT
example, mechanism and side effects of biphosphonates
alendronate,
mechanism of desunomab
decreases osteoclast activites
mechanism of strontium
increases osteoblast activity
why can osteoporosis occur post menopause
< protective oestrogen
what does a DEXA scan measure
bone mineral density
pathology of paget’s disease
increased bone turnover, increases osteoblasts and osteoclasts, thick/brittle bone layed
which bone are commonly affected by paget’s disease
axial skeleton, femur, tibia
presentation of paget’s disease
asymptomatic, elderly, pain, bony deformity, pathological fractures
complications of paget’s disease
osteoarthritis, hypercalcaemia, nerve compression, osteosarcoma, high output heart failure
what clinical sign can be seen in paget’s disease of the tibia
saber tibia
investigations for paget’s disease
> ALP, normal Ca, normal phosphorus, XR, bone scan
what is seen on xr in paget’s disease
thick trabeculae, lysis+ sclerosis
management of paget’s disease
analgesia, bisphosphonates, calcitonin, +- joint replacement
cause of primary hyperparathyroidism
adenoma, hyperplasia, malignancy of parathyroid
cause of secondary hyperparathyroidism
hypocalcaemia from < vit D or CKD
cause of tertiary hyperparathyroidism
parathyriod hyperplasia after prolonged secondary hyperparathyroidism
presentation of hyperparathyroidism
fatigue, depression, bone pain, myalgia, kidney, osteoporosis
is phosphate normal in primary hyperparathyroidism
yes
