Osteoporosis - Background

Question 1

Osteoporosis is a disease characterised by reduced ? ? ? and microarchitectural deterioration of bone tissue, leading to increased bone
? and an increased risk of ?.
WHO defines osteoporosis as bone mineral density >? SDs below that of a
young adult ?, with values between 1 and 2.5 described as ?.
Fractures related to osteoporosis are a major public health problem in
developed countries, affecting up to ?% of women and 12% of men.

Answer 1

bone mineral density
fragility
#
2.5
male
osteopenia
30%

Question 2

Pathogenesis
-In normal individuals, bone mass increases during ? to reach a peak
between 20-?, when there is a period of ? before it falls thereafter.
Women have an ? phase of bone loss after the ? as a
result of ? deficiency.

Answer 2

childhood
30
consolidation
accelerated
menopause
oestrogen

Question 3

Risk factors·

?.
? Sex.
Genetics: ?% of peak bone mass determined by genetics, also rate of bone
?.
Low peak bone mass: limited ? exercise, limited early ? intake and low body ? in childhood make up the environmental component.
Disuse: e.g. following a ?, leading to ‘disuse ?’.
?.

Answer 3

age
female
80
turnover
early
calcium
habitus
#
atrophy
smoking

Question 4

A ‘secondary’ cause of osteoporosis is identified in around ?% of male cases;

-? Hyper?: High ? leads to increase bone turnover,
which aggravates imbalances in ?/?.
-?: again increases bone turnover.
-Malabsorptive conditions: ? deficiency and secondary hyper?.
-Chronic ? disease/? disease: inflammatory ?
increase bone ? and suppress bone ?

Answer 4

50
prim
parathyroid
resorption/formation
thyrotoxicosis
calcium
pth
inflam
neoplastic
cytokines
resorption
formation

Question 5

A ‘secondary’ cause of osteoporosis is identified in around ?% of male cases;

-Steroid-induced: risk is directly related to ?/? of therapy.
–> o Steroids cause decreased ? calcium absorption and increased
? calcium excretion, leading to secondary ?.
–> o This is combined with a direct inhibition of ? activity and stimulation of osteoblast ?.
-? disease: as for steroids.
-Anorexia Nervosa: ?deficiency, ? loss and ? all
contribute.

Answer 5

50
dose/duration
intestinal
renal
hypPTH
osteoblast
apoptosis
cushings
calcium
weight
hypogonadism

Question 6

Clinically the disease is mainly ?, often picked up ? if patients are undergoing X-ray imaging for another condition, and the bones will appear more ? than normal with looser zones.

If symptoms occur, they may be;
? fractures.
? pain.
? loss.
?sis.

Answer 6

aSx
incidentally
radiolucent
fragility
back
height
kyphosis

Question 7

The most common sites for osteoporotic fractures are the ?(?), ? of
femur or ?(vertebral ?/?fracture).
After ? of these fractures is detected the patient should be referred on for bone ?·

Answer 7

wrist
colles
neck
spine
wedge
crush
one
densitometry