Osteoporosis lecture notes Flashcards
Osteoporosis definition
A systemic skeletal disease characterised by low bone mass and microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture
1 in _ women over the age of 50 will have a fracture due to osteoporosis
2
1 in _ men over the age of 50 will have a fracture due to osteoporosis
5
With ageing, there is decrease in ______ thickness
trabecular (more in non-load bearing horizontal trabeculae, more load in vertical direction so used more)
What is a T-score?
Standard deviation score
Compared with gender-matched young adult average (peak bone mass)
What is a Z score?
Standard deviation score
Compared with gender and age-matched average
What T-score classifies someone as having osteoporosis?
-2.5 or lower
What diagnosis is made for -1-to -2.5 T score?
Osteopenia
True or false: Inflammatory cytokines increase bone resorption?
True
RA, seronegative arthritis, connective tissue diseases
Thyroid hormone and parathyroid hormone ______ bone turnover
increases
C_____ increases bone resorption and induces osteoblast apoptosis?
Cortisol
O_______/ testosterone control bone turnover
oestrogen
Name some medications which increase risk of osteoporosis?
Glucocorticoids
Depo-Provera contraception
Aromatase inhibitors
GnRH analogues
Androgen deprivation
Other risk factors for osteoporosis
Previous fracture
Family history
Alcohol
Smoking
What tool is used to show 10 year risk fracture?
FRAX tool
What are anti-resorptive drugs for osteoporosis?
bisphosphonates
HRT
Denosumab
What are anabolic osteoporosis treatments?
(Increase osteoblast activity and bone formation)
Teriparatide
Romosozumab
Bisphosphonates are c___, e_____ and have many years of experience
cheap and effective
Bisphosphonates inhibit an enzyme in the ______ synthesis pathway - Farnesyl Pyrophosphate Synthase
cholesterol
Denosumab is a monoclonal antibody to ____ ligand, works within hours or minutes
RANK
Teriparatide is a PTH analogue, first a______ treatment. Subcutaneous injection
anabolic
Teriparatide is more expensive and reserved for…
those who don’t respond to bisphosphonates
Romosozumab mops up sclerostin, and is a monthly _________ injection
subcutaneous
Name properties that contribute to bone strength
bone mineral density
Size
Geometry
Microarchitecture
Turnover
