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Flashcards in OSTEOPOROSIS Deck (21):
0

Define osteoporosis.

Degenerative disease of the bone, where both mass and structure are lost, leading to weak and easily fractured bone.

1

What are the non-modifiable risk factors of osteoporosis?

Age
Gender (female)
Premature menopause
Hysterectomy
Race: white or asian much more likely than black
Family history
Previous fracture
Amenorrhea in female athletes

2

What are the modifiable risk factors for osteoporosis?

Alcohol
Smoking
Steroid use
Sustained period of immobilisation
Vitamin D deficiency
Malnutrition (especially calcium deficiency)
Underweight

3

What medical disorders have osteoporosis as a possible complication? (Name at least 7)

Any chronic disease that leads to immobilisation
Hypogonadal states such as Turner's syndrome
Some endocrine disorders (separate question for details)
Malabsorption disorders such as Crohn's
Anorexia nervosa
Rheumatoid Arthritis
SLE
Ankylosing Spondylitis
Lymphoma
Multiple myeloma
Sickle cell disease
Thalassemia
Marfan's syndrome

4

What endocrine disorders have osteoporosis as a possible complication? (Name at least 5)

Cushing's syndrome
Hyperparathyroidism
Hyperthyroidism
Hypothyroidism
Diabetes
Acromegaly
Adrenal insufficiency

5

What medications can lead to the development of osteoporosis? (Name at least 5)

Steroids
Barbiturates
Phenytoin
Thyroxine
Methotrexate
Warfarin
Heparin
PPI's
Lithium

6

What do osteoblasts do

Add bone matrix

7

What do osteoclasts do?

Resorption of bone. They are essentially macrophages.

8

Where do osteoblasts work?

They only work where osteoclasts have already resorbed bone.

9

What is the bone density threshold for osteoporosis?

2.5 SD below that of normal adult mean value

10

What is the bone density threshold of osteopenia?

1 SD below the normal density of bone

11

What is increased in the marrow of a bone affected by osteoporosis?

Adipocytes

12

What are osteocytes?

They are osteoblasts that have trapped themselves inside the bone matrix that they created. They stimulate osteoblasts and osteoclasts to recycle bone. They are connected to neighbour osteocytes.

13

Why do women get a lot more osteoporosis?

Oestrogen deficiency contributes to bone metabolism. So post menopausal women are more likely to develop osteoporosis.

14

What is the name of the cave left by the osteoclasts?

Howship's lacunae

15

What is the glycoprotein which is reduced when the levels of oestrogen decrease?

OPG - Osteoprotegerin

16

What does RANKL do?

They promote osteoclast differentiation.

17

What does OPG do?

It binds to the RANKL to prevent it from activating the RANK receptor and hence prevent the maturation of osteoclasts.

18

What is the name of the drug that does the same role as the OPG?

Denosumab

20

What part of the femur is frequently fractured in patients with osteoporosis?

The neck of the femur

20

At what age do people tend to have peak bone density?

18 for women
20 for men