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KCP > Week 7- Fractures + Osteoporosis > Flashcards

Week 7- Fractures + Osteoporosis Flashcards

1
Q

What are some functions of bone?

A

Attachment for muscles & tendons
Protection of vital organs
Red blood cell factory
Reservoir of calcium & phosphate
Involved in energy regulation

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2
Q

How can the structure of bone be described?

A

Extra-cellular matrix

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3
Q

What 4 types of cell make up bone?

A

Osteocyte
Osteoblast
Osteoclast
Osteogenic cell

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4
Q

What is the function of an osteocyte?
(Coordinators)

A

Maintains bone tissue
>90% of bone cells
Mechanoreceptors
Coordinate bone turnover and the response to injury

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5
Q

What is the function of an osteoblast?
(Builders)

A

Forms bone matrix
Live at the bone surface
Deposit new bone

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6
Q

What is the function of an osteoclast?
(Eaters)

A

Resorbs bone
Highly specialised macrophages
Degrade bone matrix

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7
Q

What is the function. of an osteogenic cell?
(osteoprogenitor)
(Pre-cursers)

A

Stem cell
Pre-cursors to osteocytes and osteoblasts

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8
Q

What is the organic component of the extra-cellular matrix?

A

Collagen (predominantly Type 1)

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9
Q

What is the inorganic component of the extra-cellular matrix?

A

Hydroxyapatite

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10
Q

What’s the definition of a fracture?

A

Discontinuity of bone, resulting from a mechanical force which exceeds the bone’s ability to withstand them

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11
Q

What are some common fractures in older adults?

A

Hip
Spine
Wrist
Humerus

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12
Q

What are the statistics for patient’s survival after a hip fracture?

A

After a hip fracture, 1/10 cases will die within one month and 1/3 are dead at one year

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13
Q

Why are fractures more likely in older adults?

A

Poorer bone quality and increased risk of falls

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14
Q

What causes the increased risk of falls in older adults?

A

Neurological impairment- stroke, visual impairment, balance, dementia
Loss of muscle muss
Environment
Medications
Arthritis

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15
Q

What is the diagnostic criteria for osteoporosis?

A

Individuals with bone mineral density (BMD) > -2.5 SD below the young normal mean (T-Score)

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16
Q

What is osteoporosis?

A

A disease characterised by low bone mass and micro-architectural deterioration of bone tissue, leading to enhanced bone fragility and increased fracture risk

17
Q

How does bone mass change with age?

A

Excessive bone resorption without compensatory bone formation

18
Q

What are some risk factors for osteoporosis?

A

Smoking
Excess alcohol consumption
Genetics- responsible for 70-80% of your peak bone mass, parental history of hip fracture
Ethnicity- risk greater in Caucasians>Asian>African
Lack of exercise
Sex hormone deficiency (menopause)
Chronic inflammatory disease e.g. Rheumatoid Arthritis
Medications- corticosteroids, oestrogen inhibitors

19
Q

How is osteoporosis diagnosed?

A

DEXA scan
Bone density compared to 30-year-old of the same sex
Used for Dx of OP in the elderly
Results-
-1 to -2.5 = osteopaenia
>-2.5 = osteoporosis

20
Q

Who would be given a DEXA scan?

A

Fragility fracture aged >50 years
Suspected vertebral fracture
Taking oral glucocorticoids
Ten-year fracture risk >10%

21
Q

What are some ways to prevent osteoporotic fractures?

A

Lifestyle
Muscle strengthening
Balance exercises
Avoid bone thinning drugs

22
Q

What things can be used to treat osteoporosis?

A

Vit D and calcium
Exercise
Anabolic drugs
Bisphosphonates

23
Q

How do bisphosphonates work in the treatment of osteoporosis?

A

They result in osteoclast apoptosis

24
Q

What are some common names of bisphosphonates?

A

Risedronate (Actonel)
Alendronate (Fosamax)
Zoledronic Acid (Reclast)
Pamidronate (Aredia)

25
Q

How do anabolic drugs work in the treatment of osteoporosis?

A

They are an antibody to sclerostin
Sclerostin inhibits bone formation
If you inhibit an inhibitor of bone formation you will increase BMD

26
Q

What are some common names of anabolic drugs?

A

Romosozumab
Teriparatide

27
Q

What are some negatives of bisphosphonates?

A

Indigestion sometimes occurs with oral bisphosphonates
Some patients do not like fasting before taking oral bisphosphonates
Intravenous bisphosphonates may cause flu-like illness for a few days after treatment (issue in Covid19-era)
Rare side effects- osteonecrosis of the jaw, increased risk of atypical femoral fractures if taken for many years

28
Q

What are some negatives of anabolic drugs (specifically Romosozumab)?

A

May increase the risk of CV events

29
Q

What do the treatments for osteoporosis focus on?

A

Preventing bone loss and/or promoting gain of bone that has been lost

KCP (9 decks)

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