osteoporosis

Question 1

define osteoporosis

Answer 1

skeletal disorder characterised by compromised bone strength and predisposing a person to an increased risk of fractures

Question 2

what happens in Osteoporosis?

Answer 2

bones are weak and brittle - new bone is not generated as fast as it is degraded hence leaving a deficit

Question 3

what appearance does OP have?

Answer 3

hollow bones

Question 4

what are the general symptoms of OP?

Answer 4

back pain, stooped posture, early menopause, aches and tiredness

Question 5

what suggest a patient has OP?

Answer 5

age, having a T score of less than -2.5, low calcidol, high parathrome

Question 6

what is a T score in relation to OP?

Answer 6

T score is the average bone mass of your specific age category and -2.5 is more than 2 standard deviations away

Question 7

what is calcidol?

Answer 7

form of vit D - vital for bones

Question 8

what is the purpose of parathormone?

Answer 8

is controls Ca2+ and having too much of PTH causes release of ca from bones

Question 9

what do osteoclasts do in bones?

Answer 9

they reabsorb bone cells for degradation

Question 10

what is the function of osteoblasts?

Answer 10

they generate new bone cells

Question 11

what is the function of osteocytes?

Answer 11

they are the longest living bone cell

Question 12

what are the treatments for OP?

Answer 12

1. anti-reabsorptives
2. PTH analogues
3. hormone therapy
4. exercise
5. cutting out smoking and drinking
6. surgery

Question 13

what is the function of anti-reabsorptives in treating OP with examples?

Answer 13

they affect osteoclasts and prevent them reabsopring and degrading the bone
eg denosumab

Question 14

what does denosumab do?

Answer 14

it is a monoclonal antibody that prevents osteoclast precursors

Question 15

give an example of an analogue of PTH?

Answer 15

teriparatade

Question 16

What prevents the mechanotransduction of osteocytes?

Answer 16

anti- sclerosis antibody

Question 17

what research has been done in NCL relating OP?

Answer 17

using 1000F study to assess sedentary behaviours and bone strength

Question 18

what links was found between bone strength and sedentary behaviours in the NCL research?

Answer 18

more sedentary time = less bone mineral density (BMD)

Question 19

what does PHE suggest about physical activity levels in the north east?

Answer 19

NE england has the largest proportion of inactive adults in the UK of which 32% of adults are doing less than 30 min of moderate exercise per week

Question 20

how much does fractures cost the NHS yearly?

Answer 20

£2.3bn a year

Question 21

why are women at most risk especially in there 50s?

Answer 21

menopause causes a drop in oestrogen and this lowers BMD

Question 22

what is the risk of fracture for a woman in her 50s?

Answer 22

50% before she dies

Question 23

what is osteogenesis imperfecta?

Answer 23

brittle bone disease

Question 24

what is the prevalence of osteogenesis imperfecta seen at birth?

Answer 24

1/ 20,000

Question 25

what is the prevalence of osteogenesis imperfecta that is not detected at birth?

Answer 25

1/ 21,000

Question 26

what does osteogenesis imperfecta entail?

Answer 26

it is a monogenic autosomal dominant disease that affects collagen synthesis, it is very dangerous intra uterine

Question 27

what is the risk of fractures with a T score of -2.5?

Answer 27

16% risk of femur fracture and 30% risk of femur/ spine and wrist

Question 28

a 2017 study expanded further into surgery for OP, what happens during an arthroplasty?

Answer 28

in hip surgery, metal plate and screws on bone cortex and hollow bony trabecula.

Question 29

what year was the 1000F study regarding sedentary behaviours and bone strength

Answer 29

2019

Question 30

what year was the study about hip surgery from?

Answer 30

2017

Question 31

how many in the UK are affected by OP?

Answer 31

3 million

Question 32

what can measure bone mass density?

Answer 32

dual energy X-ray absorptiometry (DEXA)

Question 33

what is an implication of frequent use of glucocorticoids?

Answer 33

leads to lower bone mass density

Question 34

what percentage does osteocytes make up of all bone tissue?

Answer 34

90-95%

Question 35

why is there activation of bone remodelling over the course of a lifetime?

Answer 35

to provide strength and elasticity to skeleton

Question 36

what activates osteoblasts?

Answer 36

growth hormone, interleukins, parathyroid

Question 37

what is thought to essentially initiate the activity of osteblasts?

Answer 37

osteocytes by fluid changes or microcracks within deep bone structure and sends paracrine signals to osetoblasts

Question 38

how does the wnt/ beta catenin pathway link to OP?

Answer 38

critical to osteoblast differentiate

Question 39

what is oestrogens function within OP?

Answer 39

helps promote osteoblast activity

Question 40

what is the principal regulator of bone mechanosensation and transduction?

Answer 40

osteocytes

Question 41

what affects does osteoclast activation have on osteoblasts?

Answer 41

impacts normal function - they both impact each other

Question 42

what effect does the interaction between oestrogen receptors and wnt/ beta catenin?

Answer 42

impacts the coordination of mechanical stimulation