8: Disorders of bone health including osteoporosis Flashcards Preview

Endocrine Week 4 2017/18 > 8: Disorders of bone health including osteoporosis > Flashcards

Flashcards in 8: Disorders of bone health including osteoporosis Deck (48)
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1

What is osteoporosis?

Low bone mass leading to increase in bone fragility, risk of pathological fracture

2

A ___ effect often occurs with several fractures occuring in sequence in people with osteoporosis.

domino

3

Who tends to get osteoporosis?

Elderly women

4

Where do pathological fractures commonly occur in osteoporosis?

Neck of femur

Vertebral body

Distal radius

Humeral neck

5

What percentage of hip fracture patients die within a year?

20%

6

Your risk of fracture (increases / decreases) as you get older.

increases

7

Patients with spinal fractures develop a thoracic (kyphosis / lordosis).

thoracic kyphosis

8

At which sites does bone remodelling occur?

Bone remodelling sites

I appreciate this isn't very helpful

9

What minerals are stored in bone?

Calcium

Phosphate

10

Which cells

a) resorb

b) form bone?

a) Osteoclasts

b) Osteoblasts

11

The new bone formation by osteoblasts is then mineralised with what?

Calcium

Phosphate

12

Osteoporotic bone has a reduced (mass / density).

both

13

Osteoporosis has a large ___ component.

genetic

14

People who are very (underweight / overweight) can develop osteoporosis.

underweight

15

Which hormones affect bone mass?

PTH and Calcitonin

Sex hormones

16

At what age is peak bone mass usually obtained?

Around 25

17

When do women experience a sudden drop in bone mass?

Menopause

18

Once bone mass has dropped below the __ threshold, pathological fracture is more likely.

fracture threshold

19

What are some non-modifiable risk factors for fragility fracture?

Age

Gender

Ethnicity

PMX fracture

FX

Menopause

Other diseases e.g Coeliac

20

What are some modifiable risk factors for fragility fracture?

BMD

Alcohol

Weight

Smoking

Physical activity

21

What calculators can be used to determine risk of fragility fracture?

QFracture

WHO calculator

22

People with a QFracture score of more than 10% should be referred for what?

DEXA scan

23

Who is assessed for osteoporosis?

Anyone >50 with risk factors

Anyone <50 with lots of risk factors

24

What does a DEXA scan determine?

BMD

Bone mineral density

25

What are the BMD thresholds for

a) normal bone mass

b) osteopenia

c) osteoporosis

d) severe osteoporosis?

Normal - BMD within 1 standard deviation of mean

Osteopenia - BMD > 1 SD below adult mean 

Osteoporosis - BMD > 2.5 SDs below adult mean

Severe osteoporosis - " with fragility fracture

26

What are some secondary causes of osteoporosis?

Hyperthyroidism

Hyperparathyroidism

Cushing's

Coeliac

IBD

27

What is the daily recommended intake of calcium?

700mg in normal people

1.0g per day in those with osteoporosis

28

What drugs are used to treat osteoporosis?

Calcium & Vitamin D supplementation

Oral biphosphonates or IV zoledronic acid - inhibits osteoclasts

Denosumab - inhibits osteoclasts

Teriparatide - recombinant PTH, promotes bone growth

29

Deficiency of which

a) vitamin

b) mineral

can cause osteoporosis?

Vitamin D

Calcium

30

How do biphosphonates work?

Reduce osteoclast number and activity

Bone resorption slowed down