Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Integrated Care > Osteoporosis > Flashcards

Osteoporosis Flashcards

1
Q

Is osteoporosis common?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What proportion of women over 50 will sustain an osteoporotic fracture in their lifetime?

A

1/3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What % of people with a hip fracture die within a year?

A

33%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What % of people will require help to walk 1 year after a hip fracture?

A

35%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How much do hip fracture cost the NHS per year?

A

£2 billion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How many hip fractures are there per year?

A

75,000

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is osteoporosis defined as?

A

Progressive loss of bone mass associated with changes in bone micro-architecture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What pathological process is osteoporosis linked with?

A

Reduced cross-linking within the trabecular bone, resulting in cortical thinning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is remodelling?

A

The normal process continually taking place within bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Why is bone remodelling an essential process?

A

Because it allows bone to adapt to stressors and repair microdamage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is bone remodelling the net product of?

A

Bone formation and resorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is involved in bone remodelling?

A
  • Activation of osteoclasts from circulating precursor-cells
  • Aggregation and adherence of osteoclasts to regions of active bone reabsorption on the trabecular plate
  • Osteoclastic breakdown of bone matrix
  • Simultaneous osteoblastic deposition of osteoid with subsequent mineralisation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What mediates the activation of osteoclasts from circulating precursor cells in bone remodelling?

A

Receptor binding of NF-kappaB (RANK) ligand

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What does the osteclastic breakdown of the bone matrix release in bone remodelling?

A
  • Calcium
  • Minerals
  • Active growth factors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What causes mineralisation of newly deposited osteoid in remodelling?

A

Calcium and phosphate deposition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What happens to the remodelling process in post-menopausal women?

A

There is a shift towards bone resorption, leading to net bone loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What happen to the function of osteoclasts in postmenopausal women?

A

They function in a less regulated manner

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the result of the osteoclasts functioning in a less regulated manner in postmenopausal women?

A

They perforate through the trabecular plate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the result of osteoclasts perforating through the trabecular plate in post-menopausal women?

A

There is no framework for osteoblast activity and structural integrity is lost

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the risk factors for primary osteoporosis?

A
  • Female gender
  • Previous fragility fracture
  • Maternal history of hip fracture
  • Current smoker
  • Alcohol intake >3 units/day
  • Glucocorticoids >3 months at more than 5mg/day
  • Low calcium and vitamin D deficiency
  • Low BMI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the causes of secondary arthritis?

A
  • Rheumatoid arthritis
  • Hyperthyroidism/hyperparathyroidism
  • Premature menopause
  • Chronic malabsorption or malnutrition, e.g. coeliac
  • Chronic liver disease
22
Q

What is the FRAX tool?

A

A free online resource developed WHO to calculate the 10-year fracture risk

23
Q

Why can calculating the 10-year fracture risk be helpful?

A

It can help inform decisions about treatment alongside investigations

24
Q

What investigations are done in osteoporosis?

A
  • Blood tests

- Imaging

25
What blood tests should be done in osteoporosis?
- FBC - U&Es - LFTs - TFT - Ca - PO4 - Vitamin D - PTH - Coeliac serology - Myeloma screen
26
What imaging may be done in osteoporosis?
- DEXA scanning | - Whole-spine x-ray
27
What is the gold standard diagnosis to establish a formal diagnosis of osteoporosis?
Dual energy X-ray absorptiometry (DEXA) scanning
28
How does DEXA scanning help establish a diagnosis of osteoporosis?
By measuring bone mineral density (BMD)
29
What is DEXA scanning reported as?
- T score | - Z score
30
What does the T score correspond to in DEXA scanning for osteoporosis?
The number of standard deviations above or below the bone mineral density for an average 25-year
31
What T-score represents osteoporosis?
2.5SDs below normal
32
What does the Z-score correspond to in osteoporosis?
The number of SDs above or below the bone mineral density in age-matched controls
33
What kind of fractures can DEXA be used to identify?
Moderate to severe wedge or compression fractures
34
How can DEXA scanning identify moderate to severe wedge or compression fractures?
It can provide morphometric measurements of the individual vertebrae
35
Why might a whole spine x-ray be useful in osteoporosis?
Can help identify the presence of asymptomatic fractures
36
What proportion of vertebral fractures in osteoporosis are asymptomatic?
1/3
37
What investigation into osteoporosis can be used in specialist clinics?
Bone turnover markers such as serum C-terminal telopeptide (CTX) levels
38
What can bone turnover markers be useful for in osteoporosis?
To establish compliance and effectiveness of treatment
39
What management should be commenced in all patients with osteoporotic fractures, or at risk of sustaining them?
Vitamin D supplementation
40
Is calcium co-administered with vitamin D supplementation in people at risk of osteoporotic fractures?
Depends on baseline serum calcium levels and dietary intake
41
What is the mainstay of treatment in osteoporosis?
Bisphosphonates
42
What do bisphosphonates do?
They inhibit osteoclastic bone reabsorption
43
How does the inhibition of osteoclastic bone reabsorption help in osteoporosis?
Because the processes are linked, impaired bone reabsorption results in reduced bone formation and turnover as a whole is reduced
44
How long do patients usually receive bisphosphonates?
3-5 years
45
What is the risk of keeping a patient on bisphosphonates for more than 3-5 years?
Risk of atypical subtrochanteric fracture and osteonecrosis of the jaw
46
What is required if you want to keep a patient on bisphosphonates for more than 3 years?
Reassessment of fracture risk and up to date BMD measurements
47
What BMD measurements would support the continuation of treatment?
T score or -2.5, or -2.0 if in conjunction with established vertebral fractures - indicates continued risk of fractures
48
What other drugs may be used for osteoporosis?
- Zolendronic acid - Denosumab - Raloxifene - Teriparatide
49
Give an example of an oral bisphosphate?
Alendronate
50
What are the indications for alendronate?
- Fragility fracture >75 years of age | - Post-menopausal women
51
What sites benefit from alendronate?
- Hip - Verteral - Non-vertebral

Integrated Care (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions