osteoporosis

Question 1

role of calcium (alot)

Answer 1

o Regulation of cell membrane permeability and functions, neuronal excitability and transmission of electrical impulses
o Contraction of cardiac, skeletal, and smooth muscle
o Conduction of electrical impulses in the heart
o Blood coagulation
o Platelet adhesion
o Hormone secretion
o Enzymatic activity
o Catecholamine release from the adrenal medulla
o Release of chemical mediators – histamines from mast cells
o Required for maintaining healthy bone and teeth

Question 2

what is the function of the bone?

Answer 2

structural support and reservoir for calcium and phosphate

Question 3

what is resorption

Answer 3

when serum levels are low in calcium, calcium will move from bone to blood stream

Question 4

when will calcium move from bone to blood stream

Answer 4

if serum levels are low in ca

Question 5

deposition

Answer 5

calcium from the intestines moves from diet onto bone

Question 6

when does calcium move from intestines onto bone

Answer 6

when calcium on bone is not adequate

Question 7

what is calcium deficiency caused by?

Answer 7

poor diet, hormonal altercations, medications

Question 8

when someone is calcium deifcient, calcium moves from bone into the serum to compensate (resorption) what might this result in?

Answer 8

loss of bone mass, structural function and osteoporosis

Question 9

what three hormones regulate calcium metabolism

Answer 9

PTH, Calcitonin, calcitriol

Question 10

parathyroid hormone is secreted from what gland?

Answer 10

parathyroid gland

Question 11

when are the parathyroid glands stimulated?

Answer 11

when calcium levels fall below normal

Question 12

how does parathyroid hormone work to increase calcium resorption in kidneys

Answer 12

increases resorption in the renal tubules, reducing the amount in the urine, increasing amounts in serum

Question 13

how does PTH increase the absorption of calcium in the small intestines

Answer 13

pth –> metabolism of vitamin d –> calcitriol

increases the absorption of calcium in the intestines

Question 14

what is the active form of vitamin d

Answer 14

calcitriol

Question 15

how does pth metabolize vitamin D into calcitriol

Answer 15

stimulates the metabolism of vitamin D into the active form

Question 16

where is calcitonin form?

Answer 16

thyroid gland

Question 17

when is calcitonin secreted

Answer 17

when calcium levels rise

Question 18

when calcium levels rise what is secreted

Answer 18

calcitionin

Question 19

how does calcitonin work in bone?

Answer 19

inhibits the activity of osteoclasts, stimulating the rate of bone deposition so calcium moves from serum to bone

Question 20

what stimulates calcium to move from serum to bone

Answer 20

calcitonin

Question 21

how does calcitonin work in the kidneys

Answer 21

works to inhibit resorption of calcium in the renal tubules –> more calcium excreted in the urine

Question 22

what allows for more calcium to be excreted into the urine

Answer 22

calcitonin

Question 23

what is called calcifdediol in the liver

Answer 23

calcitonin

Question 24

when is vitamin d synthesized into its active form calcitriol

Answer 24

when serum levels are low

Question 25

how does calcitriol work

Answer 25

works to enhance the intestinal absorption of calcium

Question 26

if vitamin D deficiency results in low serum levels of calcium, what is going to happen

Answer 26

increased bone resorption and it can lead to osteoporosis

Question 27

major risks of osteoporosis

Answer 27

• Major risk – female, gender, ancestry, a small lean frame, family history of osteoporosis
  o Women with advanced age, early menopause, prolonged amenorrhea, decreased estrogen level

Question 28

why would glucocorticoid administration be a risk factor for osteoporosis

Answer 28

because it inhibits bone deposition and increases bone resorption

Question 29

Smoking calcium and vitamin d deficient diet, lack of regular exercise, increased caffeine and alcohol consumption, high salt diet are what in relation to osteoporosis

Answer 29

risk factors

Question 30

treatment - how much calcium and vitamin d

Answer 30

1200 mg a day calcium

800-2000 iu a day of vitamin d

Question 31

hormone replacement therapy is recommended for

Answer 31

women with moderate to severe symptoms of menopause

Question 32

why does hormone replacement therapy work

Answer 32

ovarian hormones - estrogen and progesterone have a positive effect on bone mass density

Question 33

how do selective estrogen receptor modulators work?

Answer 33

o Acts as an estrogen receptor agonist at beta-estrogen receptors in bone
Inhibits osteoclast activity reducing the rate of bone resorption
o Acts as an estrogen receptor antagonist at alpha estrogen receptors in breast and endometrial tissue
No increased risk of breast cancer

Question 34

how do biphosphonates work?

Answer 34

increase bone mass density by inhibiting osteoclast activity, reducing bone resorption

Question 35

rankl inhibitors

Answer 35

used to treat osteoporosis - work by binding to the rank receptor on osteoclasts promoting the removal of calcium from bone

Question 36

what stimulates the upregulation of RANKL

Answer 36

estrogen deficiency, this will cause an increase in osteoclast function and significant bone loss during menopause

Question 37

why do we have significant bone loss during menopause?

Answer 37

because estrogen deficiency upregulates the rankl increasing osteoclast function

Question 38

who is the RANKL inhibitor a good choice for

Answer 38

women more susceptible to fractures

Question 39

sclerostin inhibitors

Answer 39

inhibit sclerostin

Question 40

what is sclerostin

Answer 40

small protien works to inhibit osteoblasts and bone formation

Question 41

true or false; estrogen deficiency can increase sclerostin increasing bone loss

Answer 41

true

Question 42

parathyroid is only recommended for what cases of osteoporosis

Answer 42

only very severe