Osteoporosis lecture notes

Question 1

Osteoporosis definition

Answer 1

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

Question 2

1 in _ women over the age of 50 will have a fracture due to osteoporosis

Answer 2

2

Question 3

1 in _ men over the age of 50 will have a fracture due to osteoporosis

Answer 3

5

Question 4

With ageing, there is decrease in ______ thickness

Answer 4

trabecular (more in non-load bearing horizontal trabeculae, more load in vertical direction so used more)

Question 5

What is a T-score?

Answer 5

Standard deviation score
Compared with gender-matched young adult average (peak bone mass)

Question 6

What is a Z score?

Answer 6

Standard deviation score
Compared with gender and age-matched average

Question 7

What T-score classifies someone as having osteoporosis?

Answer 7

-2.5 or lower

Question 8

What diagnosis is made for -1-to -2.5 T score?

Answer 8

Osteopenia

Question 9

True or false: Inflammatory cytokines increase bone resorption?

Answer 9

True
RA, seronegative arthritis, connective tissue diseases

Question 10

Thyroid hormone and parathyroid hormone ______ bone turnover

Answer 10

increases

Question 11

C_____ increases bone resorption and induces osteoblast apoptosis?

Answer 11

Cortisol

Question 12

O_______/ testosterone control bone turnover

Answer 12

oestrogen

Question 13

Name some medications which increase risk of osteoporosis?

Answer 13

Glucocorticoids
Depo-Provera contraception
Aromatase inhibitors
GnRH analogues
Androgen deprivation

Question 14

Other risk factors for osteoporosis

Answer 14

Previous fracture
Family history
Alcohol
Smoking

Question 15

What tool is used to show 10 year risk fracture?

Answer 15

FRAX tool

Question 16

What are anti-resorptive drugs for osteoporosis?

Answer 16

bisphosphonates
HRT
Denosumab

Question 17

What are anabolic osteoporosis treatments?

Answer 17

(Increase osteoblast activity and bone formation)

Teriparatide
Romosozumab

Question 18

Bisphosphonates are c___, e_____ and have many years of experience

Answer 18

cheap and effective

Question 19

Bisphosphonates inhibit an enzyme in the ______ synthesis pathway - Farnesyl Pyrophosphate Synthase

Answer 19

cholesterol

Question 20

Denosumab is a monoclonal antibody to ____ ligand, works within hours or minutes

Answer 20

RANK

Question 21

Teriparatide is a PTH analogue, first a______ treatment. Subcutaneous injection

Answer 21

anabolic

Question 22

Teriparatide is more expensive and reserved for…

Answer 22

those who don’t respond to bisphosphonates

Question 23

Romosozumab mops up sclerostin, and is a monthly _________ injection

Answer 23

subcutaneous

Question 24

Name properties that contribute to bone strength

Answer 24

bone mineral density
Size
Geometry
Microarchitecture
Turnover