Osteoporosis Flashcards

1
Q

definition

A

brittle bones that are prone to fracture

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2
Q

what happens to osteoclasts in osteoporosis

A

increased activity = increased bone ‘chewing’

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3
Q

what happens to osteoblasts in osteoporosis

A

underactivity in bone remodelling (no bone being ‘born’)

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4
Q

what is the overall pathophysiology of osteoporosis

A

reduced bone density = increased fragility of bone = increased risk of low impact fracture

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5
Q

aetiology of type 1 osteoporosis (2)

A

HORMONAL

post-menopausal osteoporosis OR hypogonadism in males (increased osteoclast activity)

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6
Q

aetiology of type 2 osteoporosis (5)

A
old age
steroids
alcohol
malnutrition 
vit D deficiency
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7
Q

common fractures in type 1 osteoporosis (1)

A

post menopausal = colles fractures (think granny pat and her wrists)

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8
Q

common fractures in type 2 osteoporosis (2)

A

femoral neck fracture, vertebral neck fracture (think old folks home)

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9
Q

risk factors for osteoporosis (6)

A
elderly 
females 
early menopause (always ask!)
low BMI in young people (weak bones)  
steroids 
calcium deficiency
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10
Q

what should you always ask women with ?osteoporosis

A

?early menopause

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11
Q

which drugs commonly cause osteoporosis

A

steroids

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12
Q

how do steroids cause osteoporosis

A

decrease osteoblast activity (bone isnt being ‘born’) = reduced calcium absorption

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13
Q

what can osteoporosis be secondary to (3)

A

coeliac disease
parathyroid disease
rheumatoid arthritis
lots more…

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14
Q

how does parathyroid disease contribute to osteoporosis

A

high PTH = decreases calcitonin = increases osteoclasts = increases bone breakdown (to increase the serum Ca bc PTH is usually made when serum Ca is low)

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15
Q

how does osteoporosis present in the spine

A

increased thoracic kyphosis

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16
Q

investigations for osteoporosis

A
DEXA scan 
general bloods (PTH, sex hormones) etc to see if it is secondary osteoporosis
17
Q

what is a DEXA scan

A

calculates bone mineral content and bone mineral density

18
Q

what are the 2 osteoporosis risk calculators

A

Q fracture

FRAX

19
Q

what scan is used to calculate osteoporosis severity

A

DEXA scan

20
Q

what is the T score a measure of in severity of osteoporosis (from DEXA scan)

A

number of standard deviations (SD) from normal (for patients age, sex and race) the bone mineral density is

21
Q

osteopenia criteria

A

T score between -1 and -2.5

22
Q

normal T score

A

> -1

23
Q

osteoporosis criteria

A

T score < -2.5

24
Q

severe osteoporosis criteria

A

T score < -2.5 and fracture

25
Q

complication of osteoporosis

A

gibbus

26
Q

treatment (3)

A

calcium and vit D supplementation
bisphosphonates
denosumab

27
Q

why do you give vit D supplements

A

to maximise Ca2+ absorption

28
Q

how do bisphosphonates work

A

osteoclasts kill the drug instead of bone = bone breakdown is slowed

29
Q

bisphosphonate example

A

alendronic acid

30
Q

side effect of bisphosphonates

A

atypical fractures in femoral neck

31
Q

indication for taking denosumab

A

renal failure

32
Q

mechanism of denosumab

A

inhibits osteoclasts