Osteoporosis and Other Metabolic Bone Disorders Flashcards

1
Q

What happens first in bone remodeling?

A

The osteoclasts secrete enzymes and acids that degrade bone. They then secrete messenger molecules that activate osteoblasts.

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2
Q

Osteoblasts secrete _______________.

A

osteoid

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3
Q

Where do osteocytes come from?

A

Osteoblasts

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4
Q

Osteoclasts are activated by the ligand ____________.

A

RANK

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5
Q

Osteoblasts are activated by the __________ pathway.

A

Wnt

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6
Q

Osteoporosis predisposes people to fragility fractures. What are those?

A

Fractures due to minor trauma

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7
Q

Osteoporosis is more severe than _____________.

A

osteopenia

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8
Q

In wedge fractures of the vertebra, the __________ side is narrower.

A

anterior (leading to kyphosis)

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9
Q

Once you’ve had one fragility fracture, your risk of having another is ______________.

A

fivefold

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10
Q

What is the most common critical period for bone resorption?

A

Menopause

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11
Q

What formula needs to be satisfied to mineralize bone?

A

[Ca] x [PO4] must be greater than 24

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12
Q

95% of all genetic rickets is _____________.

A

congenital hypophosphatemic rickets (resistant to vitamin D)

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13
Q

The pathognomonic radiologic finding for osteomalacia is _________________.

A

pseudofractures –lines of demineralization where arteries press against bone

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14
Q

What two things are thought to cause Paget’s disease?

A
  • Genetic predisposition

- Paramyxovirus infection

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15
Q

________________ is usually the gene implicated in familial Paget’s.

A

SQSTM (sequestasome)

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16
Q

______________ ownership has been linked to Paget’s disease.

17
Q

What symptoms are typical of Paget’s?

A

Bone pain
Fractures
Osteoarthritis
Bone deformity

18
Q

Paget’s can cause ___________ by two ways.

A

deafness (the ways being ossification of the foramen through which the cochlear nerve exits and ossification of the ossicles)

19
Q

Alkaline phosphatase is secreted by osteo-_________.

20
Q

What are the radiologic signs of Paget’s disease?

A

“Blade of grass” lesions in long bones and punched-out lesions in flat bones

21
Q

On pathologic slides, the bone of someone with Paget’s will display _______________.

A

disorganized trabeculae and expanded cortex

22
Q

How might you hear osteoclasts histologically described?

A

Multinucleated giant cells

23
Q

_______________ function as the mechanoreceptors in bone, increasing deposition of minerals when stress increases.

A

Osteocytes

24
Q

Binding to ____________ stimulates bone resorption.

25
What densitometry scores correspond to osteopenia and osteoporosis?
Osteopenia: less than 1.0 SD below average Osteoporosis: less than 2.5 SD below average
26
What doses of calcium and vitamin D are recommended in those with osteoporosis?
1,500 mg of calcium and 1,000 units of vitamin D
27
Bisphosphonates and SERMs are classified as ______________ agents.
anti-resorptive
28
What causes vitamin D-dependent Rickets types 1 and 2?
Type 1: defect of 1-alpha hydroxylase (type 1 = 1-alpha) | Type 2: defect of vitamin D receptor
29
Hypophosphatemic Rickets is also called _______________.
vitamin D resistant Rickets
30
What are the three phases of Paget's disease?
- Osteoclast predominance (5 years; high N-telopeptides) - Osteoblast predominance (10 years; alk phos elevated) - Osteoclast predominance ( indefinite; high N-telopeptides)
31
The most frequent kind of osteoporosis fracture is __________.
spinal
32
The incidence of Paget's disease went down, perhaps due to the introduction of the _________ vaccine.
measles
33
Those with ____________ also have cardiovascular features.
Paget's