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Flashcards in Bone health Deck (40):
1

what is osteoprosis

progressive skeletal disease characterized by low bone mass and deterioration of the bone tissue, with increase in bone fragility and fracture risk

2

which gender is more common female or male in osteoporosis

female

3

is osteoporosis asymptomatic or has symtoms

assymptomatic

4

where are common fracture sites in the body

neck of femur, vertebral body, distal radius, humeral neck

5

how much of the skeleton is remodeled each year

10%

6

what is normal transitioning between osteoblasts and osteoclasts

osteoclast- osteoblast numbers the same, rapid turnover and regeneration

7

what causes fractures?>

BREAKS IN THE INFRASTRUCTURE LEAD TO WEAKNESS CAUSING FRACUTRES

8

WHEN DO YOU TYPICALLY HAVE PEAK BONE MASS

LATE 20S

9

what factors can lead to bone loss

glucocorticoids, diet, weight, sex hormone deficiency, diseases, immobility

10

what is the major determinant of bone loss after the menopause?

oestrogen deficinecy

11

what does the fracture risk calculator do?

predicts 10 yearr fracture risk of major osteoporotic fractureses

12

when would you use the risk factor assessment?

over 50s, and under 50s that have history with glucocorticoid involvement and early menopause

13

when shouda DEXA scan be performed?

anyone who gets a fracture score of 10% or more

14

what does DEXA do?

measures bone density independently of anything else

15

what advice should you give for managing osteoporosis

high intensity strength training, low impact weight bearing, avoid alcohol, avoid smoking, fall prevention

16

what should post menopausal women aim for in calcium intake

1000mg

17

what drugs are used in the treatment of osteoporosis

calcium and vit D supplements, bisphosphonates, denosumab,, HRT, testosterone

18

what do calcium and vit D reduce the risk of?

non vertebral fractures

19

what are the guidelines for taking calcium and vit D supplements

cannot take calcium within 2 hours of oral bisphosphonates. If calcium in diet is adequate, vit D may be preferred for OP treatment

20

what are bisphosphonates and what do they do?

antiresorptive agents, prevent bone loss at all sites vulnerable to OP, reduce risk of hip and spine fracutre

21

how do bisphosphonates work chemically?

ingested by osteoclasts which lead to cell death thus inhibiting bone resorption. Slows bone growth

22

what T score must OP patients have to use bisphosphonates ?

less than -2.5

23

how long should bisphosphonates be used

5 years

24

how often can patients take Zoledronic acid

1 yearly IV infusion for 3 years

25

what is zoledronic

a bisphosphonate that can be taken IV

26

what is denosumab

monoclonal antibody that targets and binds with high affinity and specificity to RANKL- inhibits development and activity of osteoclasts, decreasing bone resoprtion and density

27

how is denosumab taken?

sub cut injections 6 monthly

28

what are some side effects of denosumab

hypocalcaemia, eczema, cellulitis

29

when is strontium ranelate used

3rd line treatment as fracture reduction risk not as high, contraindicated in thromboembolic disease, peripheral artery disedase, uncontrolled hypertension. DONT USE IF ALTERNATIVE METHOD AVAILABLE

30

what is teriparatide

a parathyroid hormone

31

what does teripatide do?

stimulates bone growth as opposed to oppresss cell death

32

in what patients would you use teriparatide

>65 with T score of

33

what effects do corticosteroids have on bone

reduce osteoblast formation, suppress osteoblast precursors, reduce calcium absorption. Indirectly inhibit gonadal and adrenal steroid production

34

what si pagets disease of bone

abnormal osteoclast activity and increased osteoblast activity. bnormal bone structure with reduced strength and increased fracture risk. single or multiple sites.

35

what bones does pagets disease effect

long bones- femur, pelvis, lumbar spine, skull

36

what would you present with pagets disease

bone pain, deformity, neuropathies, raised ALP,

37

What imaging would you use

isotope bone scan, XR ALP raised

38

how would you treat pagets disease

bisphosphonates if not responding to analgesia

39

what is osteogenesis imperfecta

rare group of genetic disorders affecting bone due to collagen mutation, usually autosomal dominant

40

what can osteogenesis be confused with

non accidental injury due to fracture risk as children