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Flashcards in Bone physiology Deck (69)
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1

True or False
One vertebral fracture will lead to another

True

2

What do osteoclasts do?

Resorb bone

3

What do osteoblasts do?

Put down osteoid to form new bone

4

Who should be assessed using the risk factor assessment? (2)

Anyone over 50 with risk factors
Anyone under 50 with an early menopause or on steroids

5

When should a DEXA scan be requested?

10 year risk assessment of at least 10%

6

In a DEXA scan, which value is the most important?

T value

7

What does the T value have to be to be classified as osteoporosis?

More than -2.5

8

What is a Z score?

Age matched so compares with age and size

9

When are Z scores used?

If younger than 20

10

What class of drug is given if osteoporosis is diagnosed?

Bisphosphonate

11

What are examples of bisphosphonates?

Alendronic or risedronic acid

12

When is zolendronic acid given?

If DEXA intolerable

13

What is given in severe spinal osteoporosis?

Teriparatide

14

If osteopenia is diagnosed what is done?

Lifestyle advice e.g. smoking, alcohol, weight bearing exercise, falls advice
DEXA reassessment

15

True or False
Post-menopausal women should increase their dairy intake

True

16

How do bisphosphonates work?

Apoptosis of osteoclasts so inhibit bone resorption

17

What are long term potential side effects of bisphosphonates?

Osteonecrosis of jaw
Oesophageal Ca

18

How is zolendronic acid given?

Once yearly IV infusion

19

When is denosumab given?

If bisphosphonates intolerable.

20

How should alendeonic acid be given?

Tablet, 30 minutes before food and don't lie down for half an hour after

21

When should alendronic acid be stopped?

Oesophagitis or ulcers

22

What are common side effects of alendronic acid?

Abdo pain
Nausea
dyspepsia
GI side effects

23

How does denosomuab work?

Monoclonal Ab that binds to RANKL

24

What is RANKL?

Receptor activator of nuclear factor kB ligand

25

How does activating RANKL prevent osteoporosis?

Inhibits osteoclasts and decreases bone resorption

26

How is denosomuab given?

Subcut injection 6 monthly

27

Why is strontium not recommended as 1st line?

Fracture reduction is slightly less and dangerous in heart disease

28

Where does Paget's disease affect?

Long bones
Pelvis
Lumbar spine
Skull

29

What is Paget's disease?

Increased osteoclast activity with abnormalities. Reduced strength

30

What is a complication of Paget's disease?

Osteosarcoma