Flashcards in Bone Disorders Deck (25)
Progressive decrease in bone mass and deterioration of bone tissue, causing increased fragility and susceptibility of fracture
Osteoporosis is more common in men than women. True/False?
List common fracture sites due to osteoporosis
Neck of femur
Describe the bone remodelling cycle that occurs in bone remodelling units
Osteoclasts act on an inactive surface and resorbs bone; these are then replaced by osteoblasts that fill the cavity by laying osteoid; osteoid is then mineralised to form new bone
What is the abnormal process occurring in osteoporosis?
Relative/absolute increase in bone resorption compared to formation
In women, what is the major determinant of bone loss following menopause?
What is the most widely used method of assessing bone mineral density?
Define normal BMD
Within 1 standard deviation of young adult reference mean
Define osteopenic BMD
BMD between 1 and 2.5 standard deviations below young adult reference
Define osteoporotic BMD
BMD of 2.5 or more standard deviations below young adult reference
Low BMD is proportional with increased risk of fracture. True/False?
List lifestyle advice for osteoporosis
High intensity strength training
Low impact weight-bearing exercise
Avoid smoking and alcohol
List drug treatment for osteoporosis
Calcium and vitamin D supplements
How do bisphosphonates work?
Antiresorptive agents to prevent bone loss at vulnerable sites; absorb onto bone and ingested by osteoclasts, leading to cell death
Give examples of biphosphonates
When would antiresorptive therapy be started in patients?
T score less than -2.5
List some long term concerns/complications of biphosphonates
Osteonecrosis of jaw
Which complication of osteoporosis is zoledronic acid particularly useful for?
Reduces risk + incidence of fractures
What is denosumab and why is it useful for osteoporosis?
Monoclonal antibody treatment that antagonises RANK to inhibit development of osteoclasts, resulting in increased bone density
Strontium renelate is the 3rd line treatment for osteoporosis - why?
Antiresorptive capacity is lower than bisphosphonate
Has more contraindications
What is teriparatide?
Recombinant PTH that helps stimulate bone growth
What is Paget's disease?
Abnormal osteoclast activity resulting in increased osteoblast activity
Which bones does Paget's disease typically affect?
List clinical features of Paget's disease