Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clinical Pathology > 51 Bone diseases + markers > Flashcards

51 Bone diseases + markers Flashcards

1
Q

What are the four functions of the bone?

A

Structural support.
Organ protection.
Blood cell production.
Site of mineral storage.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the two layers of bone?

Characteristics?

A

Cortical bone: outer, hard.

Trabecular: inner, spongy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What does the extracellular matrix of the bone consist of? (4).

A

Collagen.
Hydroxyapatite.
Calcium.
Phosphate.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is osteoid?

A

Non-mineralised organic matrix consisting of mainly Type 1 collagen.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is hydroxyapetite?

A

Calcium-phosphate-hydroxide salt.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Differentiate between the function of osteoclasts and osteoblasts:

A

Osteoblasts: make bone.
Osteoclasts: resorb bone.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are osteocytes?

A

Osteoblasts that are trapped in the bone matrix.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What do osteoblasts make? (4).

A

Osteoid.
Hormones (osteocalcin).
Matrix proteins.
Alkaline phosphatase.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which enzymes do osteoclasts produce? (2).

A

TRAP - tartrate resistant acid phosphatase.

Cathepsin K.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which hormones regulate osteoclast activity? (3).

A

PTH.
Calcitonin.
IL-6.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which ligands are involved in osteoclast maturation? (2).

A

RANK ligand.

Osteoprotegrin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the functions of osteoclasts? (2)

A

Mechanosensory.

Regulate bone turnover.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How often is the adult skeleton replaced completely?

A

10 years.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe the bone cycle: (4)

A

Resting.
Osteoclast resorption.
Osteoblasts make osteoid.
Mineralisation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Describe how bone mass changes with age.

A

Peaks at 30.

Decreases with age (sudden drop in menopause in women).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Name the products of active osteoblasts that are measured: (3)

A

Alkaline phosphatase.
Osteocalcin (OC).
Procollagen type 1 propeptides (P1NP).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is produced during bone resorption? (3).

A

Hydroxyproline.
Pyridinium.
Cross-linked telopeptides of type 1 collagen (NTX, CTX).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Where is alkaline phosphatase produced?

A

Bone (50%).

Liver (50%).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What causes an increase in bone alkaline phosphatase? Generally, then (4).

A 
Increase in bone remodelling.
Growth.
Fractures.
Hyperparathyroidism.
Paget's.
20
Q

Why is P1NP a good marker of bone production? (2).

A

Low diurnal and intraindividual variation.

No affected by food intake.

21
Q

What are the problems with using cross linked collagen molecules as markers?

A

Diurnal variation.

Not correlated with bone density.

22
Q

Which marker is used to measure the success and compliance of anti-resorptive therapy?

A

Cross linked telopeptides of type 1 collagen (CTX, NTX).

23
Q

Which bone marker is used to monitor compliance with terparatide?

A

P1NP.

24
Q

How is bone mass measured and quantified?

A

DEXA scanning.
T score. Between -1 and -2.5 is osteopenia.
Below -2.5 is osteoporosis.

25
Q

How is osteoporosis diagnosed?

A

DEXA scanning.

Bone markers not sensitive enough.

26
Q

Define osteoporosis:

A

Decreased bone mass +
Deranged micro architecture =
Failure of structural integrity.

27
Q

What is a fragility fracture and where do they normally occur?

A

Caused by injury insufficient to fracture normal bone.

Spine, neck of femur, wrist.

28
Q

Which tool is used to assess fracture risk?

A

FRAX.

29
Q

What are the risk factors for osteoporosis? (6).

A 
Low vitamin D.
Early menopause.
Steroid use.
Alcohol.
Smoking.
Malabsorption syndromes.
30
Q

What are the antiresorptive treatments for osteoporosis? (6).

A 
Bisphosphonates.
Denosumab.
Raloxifene.
Terparataide.
Synthetic PTH.
Strontium.
31
Q

How do bisphosphonates work?

A

Mimic pyrophosphate structure.
Taken up by osteoclasts.
Inhibit their migration and activity, and promoting apoptosis.

32
Q

What are the drawbacks of bisphosphonate use? (5).

A

Poor absorption.
Difficult to take.
Cause GI problems, jaw osteonecrosis and atypical femur fractures.

33
Q

Which malignancies cause lytic bone mets? (4).

Bone destruction

A

Brest.
Kidney.
Lung.
Thyroid.

34
Q

Which malignancies cause sclerotic bone mets? (4).

Bone deposition

A

Prostate.
Lymphoma.
Breast.
Lung.

35
Q

Where do bone mets commonly occur? (5).

A 
Spine.
Pelvis.
Femur.
Humerus.
Skull.
36
Q

How do bone mets present? (5).

A 
Pain (worse at night/constant).
Fractures.
Spinal compression symptoms.
Hypercalcaemia symtoms.
Anaemia.
37
Q

How does hyperparathyroidism cause hypercalcaemia? (3).

A

Increases bone breakdown.
Increases Ca uptake in intestines.
Increase Ca reabsorption by kidneys.

38
Q

What is tertiary hyperparathyroidism?

A

After a long time of 2o, thyroid can no longer turn off. Usually due to chronic kidney disease.

39
Q

What are the causes of primary hyperparathyroidism? (4).

A

Adenoma (85%).
Glandular hyperplasia (6-10%).
Parathyroid carcinoma (1-2%).
Ectopic adenomas.

40
Q

What are the symptoms of hypercalcaemia?

A

Polyuria, mood disturbance, vomiting, anorexia, fatigue and constipation.
Progression to cardiac arrhythmia, coma, pancreatitis.

41
Q

Which genes are associated with glandular hyperplasia of the parathyroid gland?

A

MEN1.

MEN2.

42
Q

How does primary hyperparathyroidism present? (4)

A

Hypercalcaemic symptoms.
Renal disease.
Bone disease.
Proximal muscle wasting.

43
Q

How do calcimimetics work and what are they used for?

A

Activate CasR in parathyroid gland, reduce PTH secretion.

Normalise Ca in PHPT unsuitable for surgery.

44
Q

What are the clinical features of Paget’s disease of the bone? (6).

A 
High alk phase only.
Bone pain and deformity.
Fractures.
Arthritis.
Cranial nerve defects.
Osteosarcoma risk.
45
Q

What is osteomalacia?

A

Lack of mineralisation of bone du to deficiency in Vitamin D, Ca or phosphate.

46
Q

How does osteomalacia present in children vs adults?

A

Children: widened epiphyses and poor growth.
Adults: widened osteoid seams and low mineralisation.

47
Q

What bone marker changes are seen in osteomalacia? (2)

If 2o? (2)

A

High alk phos.
Low vit D.
If 2o HPT low Ca + high PTH.

Clinical Pathology (66 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions