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ICC2 > osteoporosis and disorders of bone metabolism > Flashcards

osteoporosis and disorders of bone metabolism Flashcards

1
Q

what are the cells responsible for the bone composition ?

A

osteocytes
osteoclasts
osteoblasts

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2
Q

what receptor is responsible for the regulation of bone remodeling balance ?

A

RANKL

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3
Q

what does RANKL do ?

A

makes sure the osteoblast activity is equal to the osteoclast activity

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4
Q

what does the remodeling balance look like in growth ?

A

formation > resorption

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5
Q

what does the remodeling balance look like in aging ?

A

formation < resorption

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6
Q

what is osteoporosis ?

A

brittle bone disease where bone mineral density of more than 2.5 standard deviation below that of normal adult mean value

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7
Q

what is osteopenia ?

A

level just before osteoporosis

where the bone mineral density of more than 1 standard deviation below that of normal adult mean value

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8
Q

what are the types of osteoporosis ?

A

primary

secondary

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9
Q

what are the causes of secondary osteoprosis ?

A 
hyperthyroidism 
adrenal disease 
Rheumatoid Arthiritis 
Malignancy 
Immobilization 
Prolonged corticosteroid therapy
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10
Q

what do brittle bone disease increase the risk of ?

A

fractures

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11
Q

where are the common sites of fractures ?

A

neck of femur
vertebral fracture
wrist ( Colle’s fracture )

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12
Q

what are the modifiable risk factors of osteoprosis ?

A 
Vitamin D deficiency 
smoking 
chronic alcohol use 
low physical activity 
corticosteroids and PPI
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13
Q

which entity of people are at higher risk of developing osteoporosis ?

A

females after menopause

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14
Q

why is vitamin D deficiency a risk factor for osteoprosis ?

A

decreased vit D levels results in increased PTH causing increased bone resorption

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15
Q

what can we give patients who are at higher risk ?

A 
calcium ( 1000-1500mg/day)
vitamin D ( 400-800 IU/day)
 alongside 
Biphosphonates 
RANKL inhibitor ( denosumab)
Parathormone analogue 
Strontium ranelate 
Selective estrogen receptor modulator
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16
Q

what are the side effects of biphosphonates ?

A

osteonecrosis of the jaw
oesophaghitis
atypical femur

17
Q

what is the pharamacological name of RANKL inhibitors ?

A

Denousmab

18
Q

what is the mechanism of denosumab ?

A

inhibitionn nnof RANKL receptors thus inhibition bone resorption

19
Q

what are the side effects of denosumab ?

A

wekaness , muscle pain
constipation n
rash
decrease calcium levels

20
Q

what is the pharma name for parathormone analogue ?

A

teriparatide

21
Q

what are the side effects of teriparatide ?

A

nausea, limb pain, headache

may be related to an increase risk of osteosarcoma

22
Q

what are the side effects of strontium ranelate ?

A

nausea, diarrhea
increased risk of DVT
increased cardiovascular risk

23
Q

what is the pharma name of selective estrogen receptor modulator ?

A

raloxifen

24
Q

when is raloxifen indicated ?

A

in postmenopausal women

25
Q

what are the side effects of Raloxifen ?

A

increased risk of DVT

increased cardiovascular risk

26
Q

what does a DEXA scan interpretation tell us ?

A

T score :
is used to compare to a young healthy adult of the same gender
used to identify osteoporosis
Z score :
compared to a healthy person of the same age and gender
mainly used to identify secondary osteoporosis

27
Q

what is Pagets disease ?

A

localized disorder of the bone metabolism with osteoblastic and osteosclerotic areas ( localized osteosclerosis)

28
Q

what are the symptoms of pagets disease ?

A

nerve compression n
bone deformities
fractures
high output cardiac failure

29
Q

what are the common sites for metastatic bone disease ?

A 
breasts 
lung 
prostate 
kidney 
thyroid
30
Q

in which areas of bone metastasis may the calcium be normal ?

A

breasts and prostate

31
Q

what investigations can we perform for Pagets ?

A

ALP high
normal bone profile
normal liver profile

32
Q

what can raise ALP ?

A 
liver affection 
pregnancy 
during growth 
vitamin D deficiency 
hyperparathyroid
33
Q

where would we need to do an X-ray ?

A

pelvis

long bones

34
Q

what are the risk factors for osteonecrosis ?

A 
fracture 
smoking, alcohol 
steroids 
sickle cell anemia 
radiation 
decompression sickness

ICC2 (42 decks)

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