osteoporosis, pagets and rickets

Question 1

condition where you get increased bone turnover?

Answer 1

pagets

Question 2

what do you get an increase off in pagets which causes increased bone turnover

Answer 2

osteoblasts and osteoclasts

Question 3

what happens to the bone in pagets?

Answer 3

remodelling, bone enlargement, deformity and weakness

Question 4

what marker is raised in pagets?

Answer 4

ALP as it is a marker of osteoblast activity

Question 5

why do you get pain in pagets?

Answer 5

there are nerve endings in the periosteum which are sensitive to bone deformity and swelling.
Also effect of pressure on other tissues

Question 6

what appearance can you get in the skull in pages?

Answer 6

cotton wool appearance

Question 7

treatment of PAGETS

Answer 7

analgesia and alendronic acid to releive pain

Question 8

when does rickets become osteomalacia?

Answer 8

after fusion of epiphysis

Question 9

what is osteomalacia?

Answer 9

normal amount of bone but low mineral content

Question 10

causes of osteomalacia?

Answer 10

vitamin D deficiency 
lack of sunlight
diet
renal (1,2 dihydro... deficiency)
drug induced 
vitamin D resistance

Question 11

symptoms of rickets?

Answer 11

knock knees and bow legs

Question 12

symptoms of osteomalacia?

Answer 12

bone pain and fractures

Question 13

causes of primary osteoporosis ?

Answer 13

age related

post menopausal

Question 14

causes of 2y osteo?

Answer 14

steroids or hypogonadism

Question 15

what is the FRAX score?

Answer 15

calculates 10 year risk of fracture

takes into account age, sex, weight etc

Question 16

how do you get T score and z score?

Answer 16

DEXA bone scan

Question 17

what is a good T score?

Answer 17

between 0 and -1

Question 18

T score for osteopaenia?

Answer 18

between -1 and -2.5

Question 19

what is a T score diagnostic of osteoporosis?

Answer 19

less than -2.5

Question 20

risk factors for osteoporosis

Answer 20

slender
smoker
alcoholic
prolonged rest 
old age 
hyperPTH

Question 21

management od osteoporosis?

Answer 21

exercise
good diet
avoid smoking and excess alcohol
bisphosphonates for at risk patients

Question 22

how long do you have to be on steroids to be considered at risk?

Answer 22

3 months

Question 23

what are the side effects of alendoronic acid?

Answer 23

abdo pain, nausea, photosensitivity, oesophageal varices

Question 24

what do you supplement with in osteoporosis?

Answer 24

calcium and vitamin D

Question 25

how do bisphosphonates work?

Answer 25

encourage oestoclasts to undergo apoptosis