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MUSCULOSKELETAL > Biochemistry > Flashcards

Biochemistry Flashcards

1
Q

What is type 1 osteoporosis?

A

Post menopausal osteoporosis with exacerbated loss in the post menopausal period

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2
Q

What is type 2 osteoporosis?

A

Osteoporosis of old age with greater decline than expected

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3
Q

What are some risk factors for type 1 osteoporosis?

A

Early menopause

FH

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4
Q

What are some risk factors for type 2 osteoporosis?

A

Reduced sunlight exposure
Lack of Vitamin D
Inactivity

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5
Q

Which fractures are associated with type 1 osteoporosis?

A

Colles fractures

Vertebral insufficiency fractures

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6
Q

Which fractures are associated with type 2 osteoporosis?

A

Femoral neck fractures

Vertebral fractures

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7
Q

Risk factors for osteoporosis

A 
Early menopause 
Alcohol abuse 
Corticosteroids 
Malnutrition 
Chronic disease 
Endocrine disorders
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8
Q

How is osteoporosis diagnosed?

A

DEXA scanning - this measures bone mineral density

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9
Q

There are no treatments to increase bone mineral density after a diagnosis of osteoporosis

T/F

A

True

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10
Q

How can osteoporosis be managed?

A

Calcium and Vit D supplements

Bisphosphonates e.g alendronate

Monoclonal antibodies e.g desunomab

Zoledronic acid (once yearly IV bisphosphonate)

Hormonal replacement therapy

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11
Q

Which is a risk factor for osteoporosis; High BMI/ Low BMI

A

Low BMI

High BMI is not a risk factor for osteoporosis - however it is important to recognise that obesity can cause joint problems due to increased load

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12
Q

Qualitative defect of bone with abnormal softening

What condition is this?

A

Osteomalacia

Rickett’s in children

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13
Q

Pathophysiology of osteomalacia/ rickett’s?

A

Deficient mineralisation of osteoid secondary to inadequate amounts of calcium and phosphorus

Insufficient calcium absorption from the intestine due to lack of dietary calcium or deficiency of/ resistance to the action of Vit D

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14
Q

What are some causes of osteomalacia/ rickett’s?

A 
Malnutrition 
Malabsorption 
Lack of sunlight 
Anticonvulsants 
CKD 
Alcohol abuse (impairs phosphate absorption)
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15
Q

What are the signs and symptoms of osteomalacia/ rickett’s?

A

Bone pain
Hypocalcaemia symptoms (muscle cramps, irritability e.t.c)
Deformities
Pathological fractures

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16
Q

How can osteomalacia/ rickett’s be managed?

A

Vit D, calcium and phosphate supplementation

17
Q

What causes primary hyperparathyroidism?

A

Benign or malignant tumours
Hyperplasia

*PRIMARY - problem with the gland itself

18
Q

What would be the expected biochemistry results of a patient with primary hyperparathyroidism?

A

High PTH
High calcium
High ALP
Phosphate levels low or normal

19
Q

Primary hyperparathyroidism would present with symptoms of HYPER or HYPO calcaemia?

A

Hypercalcaemia

Symptoms may include; fatigue, depression, bone pain, myalgia, thirst, polyuria, renal stones

20
Q

What causes secondary hyperparathyroidism?

A

Physiological overproduction of PTH occurs secondary to hypocalcaemia

Most common causes include vitamin D deficiency and CKD

21
Q

What would be the expected biochemistry results in a patient with secondary hyperparathyroidism?

A

High PTH
Low calcium
High phosphate
High ALP

22
Q

What causes tertiary hyperparathyroidism?

A

Occurs after many years of secondary

Usually CKD patients

23
Q

What would be the expected biochemistry results in a patient with tertiary hyperparathyroidism?

A 
High PTH 
High/ normal calcium 
High ALP 
Low/ normal Vit D 
Low/ normal phosphate
24
Q

Which condition causes bony enlargement with thickened cortices and trabeculae with mixed areas of lysis and sclerosis?

A

Paget’s disease

Bones are brittle and misshapen and fracture easily

25
Q

Osteoblasts and osteoclasts

Which does what

A

osteoBlasts - bone is BORN

OsteoClasts - bone is Chewed

26
Q

High output cardiac failure can occur as a consequence of which condition?

A

Paget’s disease

This is due to increased blood flow through pagetic bone

27
Q

How is paget’s disease managed?

A

Bisphosphonates
Calcitonin
Joint replacement/ stabilisation

28
Q

What would be the expected biochemistry results in a patient with paget’s disease?

A

Normal biochemistry except High ALP

29
Q

How is paget’s disease managed?

A

Bisphosphonates
Calcitonin
Joint replacement/ stabilisation

MUSCULOSKELETAL (3 decks)

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