Osteoporosis Flashcards

(32 cards)

1
Q

definition

A

brittle bones that are prone to fracture

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2
Q

what happens to osteoclasts in osteoporosis

A

increased activity = increased bone ‘chewing’

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3
Q

what happens to osteoblasts in osteoporosis

A

underactivity in bone remodelling (no bone being ‘born’)

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4
Q

what is the overall pathophysiology of osteoporosis

A

reduced bone density = increased fragility of bone = increased risk of low impact fracture

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5
Q

aetiology of type 1 osteoporosis (2)

A

HORMONAL

post-menopausal osteoporosis OR hypogonadism in males (increased osteoclast activity)

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6
Q

aetiology of type 2 osteoporosis (5)

A
old age
steroids
alcohol
malnutrition 
vit D deficiency
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7
Q

common fractures in type 1 osteoporosis (1)

A

post menopausal = colles fractures (think granny pat and her wrists)

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8
Q

common fractures in type 2 osteoporosis (2)

A

femoral neck fracture, vertebral neck fracture (think old folks home)

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9
Q

risk factors for osteoporosis (6)

A
elderly 
females 
early menopause (always ask!)
low BMI in young people (weak bones)  
steroids 
calcium deficiency
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10
Q

what should you always ask women with ?osteoporosis

A

?early menopause

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11
Q

which drugs commonly cause osteoporosis

A

steroids

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12
Q

how do steroids cause osteoporosis

A

decrease osteoblast activity (bone isnt being ‘born’) = reduced calcium absorption

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13
Q

what can osteoporosis be secondary to (3)

A

coeliac disease
parathyroid disease
rheumatoid arthritis
lots more…

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14
Q

how does parathyroid disease contribute to osteoporosis

A

high PTH = decreases calcitonin = increases osteoclasts = increases bone breakdown (to increase the serum Ca bc PTH is usually made when serum Ca is low)

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15
Q

how does osteoporosis present in the spine

A

increased thoracic kyphosis

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16
Q

investigations for osteoporosis

A
DEXA scan 
general bloods (PTH, sex hormones) etc to see if it is secondary osteoporosis
17
Q

what is a DEXA scan

A

calculates bone mineral content and bone mineral density

18
Q

what are the 2 osteoporosis risk calculators

A

Q fracture

FRAX

19
Q

what scan is used to calculate osteoporosis severity

20
Q

what is the T score a measure of in severity of osteoporosis (from DEXA scan)

A

number of standard deviations (SD) from normal (for patients age, sex and race) the bone mineral density is

21
Q

osteopenia criteria

A

T score between -1 and -2.5

22
Q

normal T score

23
Q

osteoporosis criteria

A

T score < -2.5

24
Q

severe osteoporosis criteria

A

T score < -2.5 and fracture

25
complication of osteoporosis
gibbus
26
treatment (3)
calcium and vit D supplementation bisphosphonates denosumab
27
why do you give vit D supplements
to maximise Ca2+ absorption
28
how do bisphosphonates work
osteoclasts kill the drug instead of bone = bone breakdown is slowed
29
bisphosphonate example
alendronic acid
30
side effect of bisphosphonates
atypical fractures in femoral neck
31
indication for taking denosumab
renal failure
32
mechanism of denosumab
inhibits osteoclasts