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Flashcards in Bone Disorders Deck (25)
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1

Define osteoporosis

Progressive decrease in bone mass and deterioration of bone tissue, causing increased fragility and susceptibility of fracture

2

Osteoporosis is more common in men than women. True/False?

False
Women

3

List common fracture sites due to osteoporosis

Neck of femur
Vertebral body
Distal radius
Humeral neck

4

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

5

What is the abnormal process occurring in osteoporosis?

Relative/absolute increase in bone resorption compared to formation

6

In women, what is the major determinant of bone loss following menopause?

Oestrogen deficiency

7

What is the most widely used method of assessing bone mineral density?

DEXA scan

8

Define normal BMD

Within 1 standard deviation of young adult reference mean

9

Define osteopenic BMD

BMD between 1 and 2.5 standard deviations below young adult reference

10

Define osteoporotic BMD

BMD of 2.5 or more standard deviations below young adult reference

11

Low BMD is proportional with increased risk of fracture. True/False?

True

12

List lifestyle advice for osteoporosis

High intensity strength training
Low impact weight-bearing exercise
Avoid smoking and alcohol
Diet management

13

List drug treatment for osteoporosis

Calcium and vitamin D supplements
Biphosphonates
Denosumab
Teriparatide
Strontium ranelate
HRT
SERMs
Testosterone

14

How do bisphosphonates work?

Antiresorptive agents to prevent bone loss at vulnerable sites; absorb onto bone and ingested by osteoclasts, leading to cell death

15

Give examples of biphosphonates

Alendronate
Risedronate

16

When would antiresorptive therapy be started in patients?

T score less than -2.5

17

List some long term concerns/complications of biphosphonates

Osteonecrosis of jaw
Oesophageal cancer
Atypical fractures

18

Which complication of osteoporosis is zoledronic acid particularly useful for?

Reduces risk + incidence of fractures

19

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

20

Strontium renelate is the 3rd line treatment for osteoporosis - why?

Antiresorptive capacity is lower than bisphosphonate
Has more contraindications

21

What is teriparatide?

Recombinant PTH that helps stimulate bone growth

22

What is Paget's disease?

Abnormal osteoclast activity resulting in increased osteoblast activity

23

Which bones does Paget's disease typically affect?

Long bones
Pelvis
Lumbar spine
Skull

24

List clinical features of Paget's disease

Bone pain
Deformity
Deafness
Compression neuropathy

25

What is the main treatment for Paget's disease?

Biphosphonates