osteoporosis an sepsis Flashcards
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difference in Osteomalacia, Osteomyelitis, Osteoarthritus, Osteoporosis
malacia - loss of bone mineral
myelitis - infection of bone (bacterial)
arthritis - disease of joints
Porosis- loss of entire bone substance
what causes fractures of non-traumatic origin
osteoporosis
What is the WHO BMD score
at least 2.5 SD’s
what is a T score vs a Z score
T = BMD Z = age matched score
How is BMD measured
Dual energy X ray Absorptiometry (DEXA)
what bones are used in DEXA
lower spine and hips
why do you want to avoid steroids
osteoporosis
what are osteoblasts
bone forming cells
what are osteoprogenitors
pre cursers to osteoblasts
what are osteocytes
entrapped within matrix that they put down as osteoblasts
what is an osteoid
un mineralised matrix
who mineralises the osteoid
osteoblasts
what are marrow cells
osteoclast progenitor cells
what are osteoclasts
large multinucleate cells and they re-absorb bone
difference in bone modelling and bone remodelling
modelling is growing bone in early life and remodelling is maintaining the skeleton
what does oestrogen do on osteoclast do
it suppresses the little shits )increases apoptosis of osteoclasts)
and suppresses osteoclast differentiation
what do osteoblasts produce under oestrogen
IGF1
TGFB(beta)
what does oestrogen do for osteoblasts
regulates proliferation
how do osteoclasts and osteoblasts blasts chat
IL6 and RANK/RANKL
where are the oestrogen receptors on the osteoclasts
on the nucleus
what is more important in bone regulation in men Testosterone vs oestrogen
Oestrogen
Ca+ down
PTH up
what happens next
vit D3 production in skin transformed in liver from 25 OH to 1,25D and this promotes calcium resorption through the gut
what happens with steroids (corticosteroids)
reduces calcium absorption of the gut
bone loss due to action on osteoblasts
reduces number and activity
What is sepsis triggered by
infection
what are the warning signs of sepsis
• Fever • Rapid or difficult breathing • Elevated heart rate • New disorientation, confusion or drowsiness • Severe muscle or joint pains • Passing no urine • A sense of impending doom • Skin rash, mottled or discoloured • Poor feeding (in infants and children)
How to confirm (diagnose) sepsis
Blood cultures most common sample in sepsis as often do not know infection site
how to improve patient outcome in sepsis
early treatment
is MRSA usually associated with sepsis
no
what bug is normally associated with sepsis
staphococclyous areus
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