Nutritional and Metabolic Bone Dz (Pead) Flashcards

1
Q

Where are 1* and 2* centres of ossification?

A

1 - first formation of bone eg. with long bones = the centre of the shaft
2- epiphysial growth plates

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2
Q

How does the skeleton of a developming aimla idffer to adult on rads?

A
  • ^ joint space
  • epiphysial growth plates not ossified
    > massive roduction adn turnover for new bone formation (raw materials)
  • continues as an adult and calcium can act as a store of calcium
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3
Q

Potential presentations of nutritional/metabolic bone diesease

A
  • young animals
  • deviation of limbs, poor posture, weakness
  • axial skeleton as well as appendiculr
  • dietary problems
  • comparison with littermates
  • pathological fx (underlying causei n the bone -> weakness, no hx of trauma)
  • geeralised disease
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4
Q

Outlien how calcium deficiency may impact musculoskeletal systems

A
  • esential for neuromuscular function
  • serum levels highly protected (for cardiac function) at the expense of bones
  • Hydroxyapetite (Calcium phosphate OH) ‘robbed’ to protect serum Ca
    > serum calcium NOT ALWAYS AFFECTED in calcium deficiency
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5
Q

What are ca levels controlled by?

A
  • PTH stimulated with v Ca (to maintain plasma Ca)
  • ^ ca absorptioin, v excretion, ^ Ca from bone
    > PTH stimulates osteoblasts which stimulate osteoclasts to destroy bone
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6
Q

How may 2* hyerpaathyroidism be seen on rads?

A
  • path fx

- less of a difference between cortex and medulla

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7
Q

Causes of 2* nutritional hyperparathyroidism ? Pathogenesis?

A
  • v dietary calcium
  • ^ dietary phosphate
  • ^ PTH
  • serum calcium often protected
  • bones malformed/poorly formed
  • usually only see in growing animals (v unusual for dietary ca to be too low in adults)
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8
Q

Tx hyperparathyroiism with path fx in the young animal?

A
  • excercise restriction

- Ca controlled diet

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9
Q

When are calcium deficiencies commonly seen?

A
  • exotics

- pets usually fed commercial diet (will be balanced)

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10
Q

Where is active vit D sythesised? Actions?

A
  • Kidney
  • Ca release
  • ^ absorption in the GIT
  • v excretion
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11
Q

Is Vit D deficiency common in animals? How does this manifest young animals and adults?

A
  • very rare on its own
    > Ca, Vit D and UV light combination diseases more common
  • Juvenile - Rickets
  • Adult - Osteopenia
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12
Q

Which animals are predisposed to vit D/Calcium/UV light diseases?

A
  • iguanas and chelonians
  • called “metabolic bone disease” as pathophysiology not fully known
  • v activation of vit D3
  • v phosphate excretion (phosphate binds calcium, serum clacium lowered)
  • ^ PTH drive -> bone problems
  • low dietary availablility of calcium and decresed activation/availablitiy of vit D
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13
Q

Presentation/history of metabolic bone disease in reptiles? DXX?

A

> Hx: lethargy
PE: activity movement/lameness/joint swelling, limb swelling, muscle atrophy
Rads: joints limbs and spine, egg binding, spontaneous fx
BLoods: Low Ca

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14
Q

Ddx for metabolic bone diease in reptiles?

A
  • gout (deposition of urate crystals)
  • septic arthritis
  • spinal spondylosis
    > confirmation:
  • swollen bones, poor density
  • low serum Ca (tail v)
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15
Q

Tx metabolic bone disease?

A
  • ca gluconate
  • dietary adjustment (2% Ca diet)
  • UV light or direct sunlight
  • monitor blood Ca
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16
Q

When is 2* renal hyperparathyroidism seen?

A
  • CKD (usually adults)
  • v activation of vit D
  • v phosphate excretion (phosphate binds calcum -> v serum calcium)
17
Q

Where is renal hyperparathyrid commonly manifested?

A

Mandible becomes soft and pliable

18
Q

How can hormones mipact musculoskeletal system?

A
  • loss of oestrogen pulses -> post-menopausal osteoporosis

> problem NOT seen in spayed bitches (bne loss for ~12 weeks then recover)

19
Q

Which diseases are often called “metabolic” bone dz?

A

termed this as hard to classify
> calcinosis circumscrimpta
- response to injury?
- deposition of calium around joints
> craniomandibular osteopathy
- immune mediated
> metaphyseal osteopathy
- pain and fever concurrently
= hyertrophic osteodystrophy (HOD)
- associated w/ distemper
- transeint ~ 1 wweek
- Tx symptomatically (analgesia and IVFT)
> Panosteitis
- growing animals
- inflam endostium -> laying down of new bone
- growing pains, self limiting but painful on palp
> hypertrophic pulmonary osteoarthropathy (Marie’s dz)
- distal limb periosteal activation d/t thoracic/abdo tumour secreting growth factors

20
Q

How ae long bones formed?

A

Endochondral ossification