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Endocrine Clin med > metabolic bone disease > Flashcards

metabolic bone disease Flashcards

1
Q

What is the cause of Type 1 primary osteoporosis

A

postmenopausal

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2
Q

What is the cause of type 2 primary diabetes

A

age (>70)

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3
Q

What is secondary osteoporosis

A

bone loss associated with other conditions

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4
Q

What hormone deficiency can expedite bone loss

A

estrogen

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5
Q

What medications can expedite bone loss

A

corticosteroids

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6
Q

Is osteoporosis quantitative or qualitative

A

quantitative

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7
Q

When does osteoporosis generally present and why

A

older age because after 30 bone remodeling becomes unbalanced
Bone resorption>bone formation

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8
Q

What are some modifiable factors with osteoporosis

A

ETOH, smoking, low body weight
sedentary life style
low ca, low vitamin D, corticosteroids

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9
Q

What are non-modifiable facts for osteoporosis

A

advanced age
caucasian or asian
female sex

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10
Q

What is the most common presentation for osteoporosis

A

asymptomatic
*generally a fragility fx (vertebral>hip>pelvis)

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11
Q

What is generally the source for a fragility fracture

A

typically, fall from standing height or less/ no identifiable trauma

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12
Q

What is the gold standard for diagnosis osteoporosis

A

DEXA

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13
Q

What are the indications for bone density testing

A

All postmenopausal women >65
Men >75
clinical risk fx/ hx prior fx

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14
Q

What is the DEXA score for someone with osteoporosis

A

-2.6 to -4

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15
Q

What is the DEXA score for osteopenia

A

-1 TO -2.5

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16
Q

if the T score is -1 to -1.5, when does the next DEXA need to be

A

Q 5 years

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17
Q

What is the T score range in those who need DEXA scans every 3-5 years

A

T score -1.5 to -2

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18
Q

When is a DEXA every 1-2 years required

A

t score <-2

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19
Q

What tests should be run to check for osteomalacia

A

Vitamin D level

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20
Q

What is the best measurement for vitamin D levels

A

25- hydroxyvitamin D

21
Q

What is the best treatment for osteoporosis

A

Prevention 1st line

22
Q

What are some preventative measures for osteoporosis

A

weight bearing exercise
fall prevention strategies
adequate Ca
Adequate vitamin D
ETOH reduction

23
Q

What is the recommended daily amount of Ca

A

1200mg

24
Q

What are the requirements for pharmacological treatment of osteoporosis

A

Tscore < -2.5 (w/o secondary cause)

Osteopenia & 10yr hip fx risk >3%

10yr major hip fracture risk >10%

Any patient with fragility fracture

25
Q

What is the first line pharmacologic agent for osteoporosis

A

bisphosphonates (Alendronate)

26
Q

What are some side effects to watch for with bisphosphonates

A

Heart burn
acute inflammation
Osteonecrosis of the jaw

27
Q

How is Danuzomab administered as a pharmacological treatment for osteoporosis and when is it utilized

A

IV 2x a year

When pt. cannot tolerate / are unresponsive to bisphosphonates

28
Q

What is osteomalacia

A

Disorder of bone characterized by decrease in mineralization of newly formed osteoid at sites of bone turnover

29
Q

What is the cause of osteomalacia

A

Vitamin D deficiency
*effects only bones

30
Q

What is the cause of rickets

A

Vitamin D deficiency in children
*effects bone and cartilage

31
Q

What pharmacological agents may cause osteomalacia

A

phenytoin
carbamazepine
Valproate
Barbituates

32
Q

What can cause a vitamin D deficiency

A

Lack of sunlight
lack of fortified food
absorption problems
renal disease

33
Q

How much exercise is recommended for preventing osteoporosis

A

30 min, 3x/week

34
Q

What is the presentation of osteomalacia

A

diffuse muscle weakness
waddling gait
bone pain
**Children with rickets develop permanent skeletal deformities

35
Q

What is seen on XR that are diagnostic for osteomalacia

A

milkman lines (psuedofractures)

36
Q

how do you treat osteomalacia

A

high dose vitamin D
Phosphate supplement
Calcium supplementation

37
Q

Which gender is at higher risk of pagets

A

men (>55y/o)
caucasian

38
Q

What is Paget’s disease

A

inflammatory disorder of the bone
-accelerated rate of bone remodeling resulting in overgrowth of bone in aging skeleton

39
Q

What area of the body is typically effected by Paget’s disease

A

Skull
spine
pelvis (m/c)
long bones
ribs

40
Q

What will be seen on labs in someone with pagets disease

A

alkaline phosphatase is high (marker of high bone turnover)

41
Q

How is Pagets disease typically diagnosed

A

via radiographs
-thickened corticles
-lytic/blastic lesions
-cotton ball skull appearance
-picture frame spine appearance

42
Q

What is the mainstay treatment for Pagets disease

A

bisphonsphonates

43
Q

What is osteogenesis imperfecta

A

Brittle bone disease
*genetic bone disorder

44
Q

What are the MSK presentations of Osteogenesis imperfecta

A

Fragile bones
deformities (bowing legs)
ligamentous laxity
short stature
scoliosis

45
Q

What are general presentations of osteogenesis imperfecta

A

Blue sclera
brownish teeth
Aortic regurge
triangle facies

46
Q

What is the beast treatment for osteogenesis imperfecta

A

Prevention of fractures

47
Q

What is fibrodysplasia ossificans progressiva

A

Rare disorder characterized by progressive extra-skeletal ossification of soft tissues = the original skeleton being encased in unyielding new bone

48
Q

What do those with fibrodysplasia ossificans progressiva die from

A

cardiorespiratory failure

Endocrine Clin med (6 decks)

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