Bone Health Flashcards
(29 cards)
What are the 2 types of bone that make up the body?
Cortical bone
Trabecular bone
What are the functions of bone?
Structural support
Attachment of muscles for locomotion
Storage
Haematopoiesis
Protection
Aids respiration
What is the role of bone in storage?
Stores:
Ca2+
Phosphate
Acts as a buffer for the blood
What are the determinants of bone health?
Genetics
Calcium
Vitamin D
Physical activity
Smoking
Alcohol
Hypogonadism
Malnutrition
Drugs
What medications often negatively impact bone health?
Corticosteroids
Anticonvulsants
Long term PPIs
Statins
What are some anticonvulsants that can negatively impact bone health?
Phenytoin
Carbamazepine
Sodium valproate
Gabapentin
Levetiracetam
How much calcium does the average adult need a day?
700mg per day
What affects calcium levels in the body?
Diet
Intestinal absorption
Skeletal resorption
Urinary excretion
What are the main sources of dietary calcium?
Dairy
Nuts
Leafy vegetables like broccoli
Why is calcium needed for bone health?
Needed to form strong hydroxyappetite crystals to give strength too the bone
How is vitamin D metabolised in the body?
Sunlight activates the cholesterol precursor of vitamin D in the skin
This then gets converted to inactivated Vitamin D in the liver (25-hydroxyVitamin D)
Then kidneys activate 25-hydroxyVitamin D into active vitamin D
What are the risks for developing Vitamin D deficiency?
+65yrs
Low/no sun exposure
Darker skin
Malabsorption
Severe liver disease
End stage renal failure
Pregnancy
Obesity
Mediations
How can you prevent developing vitamin D deficiencies?
Supplements
Adequate sunlight exposure
How many international units should a person take when taking vitamin D supplements?
400 IU
What are the risks of having vitamin D deficiency?
Osteoporosis
Osteomalacia
Rickets (Children)
Fragility fractures
Muscle weakness
How can Hyperparathyroidism cause osteomalacia or osteoporosis?
PTH increases osteoclast activity
How much exercise should people over 65+ get to help reduce the risk of developing vitamin D deficiency?
150mins moderate intensity exercise every week
Muscle strengthening twice per week
What is the definition of osteoporosis?
Decreased bone mass with altered bone architecture and increased skeletal fragility
How do you diagnose osteoporosis?
Fragility fracture
And/or
T score < -2.5 from DEXA scan
What is the definition of a fragility fracture?
Fracture that occurs due to mechanical forces that doesn’t usually cause fractures
Bones typically squash down on itself
Who do you screen for osteoporosis?
65+ and all men 75+
Anyone with risk factors
Previous fragility fractures
Glucocorticoids
Hx of falls
Low BMI
Smoking
High alcohol intake (14 units +)
What is the process of screening for osteoporosis?
Do DEXA scan ( T score < -2.5 = osteoporosis)
Use WHO FRAX score if cant do DEXA scan
How do you manage osteoporosis?
Vitamin D + Ca2+ (need to replenish)
Bisphosphonates
Normally enough above
SERMs
Parathormone
Biologics
What are some bisphosphonates given for osteoporosis?
Allendronic acid
Zolendronic acid
