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Flashcards in Osteoporosis Deck (47):
1

What is the function of osteoprogenitor cells?

To give rise to osteoblasts (they are the stem cell population)

2

What is the function of osteoblasts?

Responsible for bone formation

3

Where are osteoblasts located/positioned?

They cover the surface of bone

4

What is the function of osteocytes?

Maintain the bone matrix through cell-cell communication and influence bone remodelling; they are also mechanosensing

5

Where are osteocytes found?

Embedded in lacunae

6

What is the function of osteoclasts?

Resorb bone matrix by demineralisation

7

What are osteoclasts derived from?

Haematopoietic cells

8

Between what ages is bone gained?

0-25

9

1 must be greater than 2 in order for bone gain to occur. What do 1 & 2 stand for?

1: formation
2: resorption

10

Between what ages is bone mass fairly stable?

25-35

11

Beyond what age is bone lost?

35

12

What are the figures for people affected by osteoporosis for men & women respectively?

1 in 12 men
1 in 3 women

13

List 3 structural differences in osteoporotic bone when compared to normal bone.

Decreased size of osteons (Haversian system)
Thinning of trabeculae
Enlargement of Haversian and marrow spaces

14

List some risk factors associated with osteoporosis (5).

Genetic/gender
Lifestyle/nutritional
Medical conditions
Drugs
Previous fragility fracture

15

Name two non-environmental factors that affect bone mass substantially.

Age
Gender

16

List some lifestyle and nutritional risk factors of osteoporosis.

Smoking
Excess alcohol
Sedentary
Prolonged immobilisation

17

List 5 medical conditions that could potentially predispose to osteoporosis.

Possible answers:
Annorexia nervosa
Rhumatoid arthritis
Early menopause (i.e.1 year)
Hyperthyroidism
Primary hyperparathyroidism
Multiple myeloma
Transplantation
Chronic renal, pulmonary or GI disease
Cushing's disease/syndrome

18

List some drugs that could increase the risk of osteoporosis.

Chronic corticosteroid therapy (increase risk of fracture by 2-3x)
Excessive thyroid therapy
Gonadotrophin releasing hormone agonist or antagonist
Anticoagulants
Anticonvulsants
Chemotherapy

19

What fracture type and by how much does a previous wrist fracture increase the risk of?

Future hip fracture: x2
Future vertebral fracture: x3

20

List the 6 non-modifiable risk factors for osteoporosis

Gender
Age
Previous fracture
Family history
Long term steroid therapy
Race

21

List the 7 modifiable risk factors for osteoporosis.

Oestrogen deficiency
Smoking
Alcohol
Low calcium
Low BMI
Vitamin D deficiency
Inactivity

22

What is the name given to Type 1 osteoporosis?

Post menopausal

23

What type of bone does Type 1 osteoporosis mainly affect?

Cancellous

24

What type of bone fracture is common in Type 1 osteoporosis?

Vertebral fracture
Distal radius fracture

25

What hormone loss is Type 1 osteoporosis related to?

Oestrogen

26

What is the ratio of females to males that suffer from type 1 osteoporosis?

6:1

27

What type of bone does Type 2 osteoporosis mainly affect?

Both cancellous & cortical bone

28

What type of bone fracture is common in Type 2 osteoporosis?

Hip fracture
Pelvic facture

29

What compound/mineral lack is Type 2 osteoporosis related to?

Calcium - related to poor calcium absorption

30

What is the ratio of females to males that suffer from type 2 osteoporosis?

2:1

31

What is the 'title' given to Type 2 osteoporosis?

Age related in those over 75 years

32

What brings about disuse osteoporosis?

Not enough pressure or force is put on the bones

33

What is the result of disuse osteoporosis?

Low energy trauma frequent
Increase in bone fragility

34

Name the 4 most common sites for osteoporotic bone fracture

Distal radius
Neck of femur
Vertebral body
Proximal humerus

35

Give the stats on hip fractures, i.e. what percentage are fatal, recover fully, are permanently disabled.

Fatal: 20-30%
Full Recovery: 30%
Permanent disability: 50%

36

What type of investigations are carried out in diagnosis of osteoporosis?

Blood tests
FBC (full blood count)
Serum biochemistry
Bone profile
Thyroid function tests
Testerostone & gonadotrophin levels (in men)
X-ray of lumbar & thoracic spine
Bone mineral density

37

What is used to measure bone mineral density?

DEXA (dual-energy x-ray absorptiometry scan)
Two distinct energy peaks - one absorbed by soft tissue, the other by bone

38

How would you calculate Bone Mineral Density?

Subtract one peak from the other (from DEXA)

39

With regard to DEXA scores, what is the T score?

A comparison with a young adult of the same gender with peak bone mass

40

A T score of greater than -1 is ... ?

Normal

41

Between what T scores is a bone classes to be osteopenic (bone thinning)?

-1 ---> -2.5

42

A T score of less than -2.5 is typical of ... ?

Osteoporosis

43

What is the Z score?

A comparison of the patient's bone mineral density with data from the same age/sex/size

44

List the 5 forms of treatment for osteoporosis.

Bisphosphonates
Anabolic Agents
Ca2+ Supplements
Hormone replacement therapy
Increase exercise

45

Name 2 anabolic agents.

Intermittant PTH
Strontium ranelate

46

Name 2 bisphosphonates.

Alendronate
Risedronate

47

What is the function of bisphosphonates?

Disrupt osteoclast activity