Metabolic bone disease

tomi1's version from 2017-03-07 23:24

Section 1

Question Answer
osteoporosis decreased one mass T score <-2.5 - bone strength lowered
osteopeniadecreased bone mass T score <-1 - precursor to osteoporosis
ricket's and osteomalacia pathologydecreased bone mineralisation (Ca/Ph/vitD)- soft bone
paget'sexcessive bone destruction and disorganised bone regrowth
primary causes of osteoporosisidiopathic/age-related
secondary causes of osteoporosishyperthyroidism, PTH,RA, IBD,Cusing,anorexia,mutiple myeloma,hypogonadism

Section 2

Question Answer
modifiable RF osteoporosisalcohol, low vit d+c, low exercise, SMOKING
non-modifiable RF osteoporosisage,female,white/asian,FH,early menopause
action of oestrogen on boneinhibits osteoclasts
types of fractures in osteoporosiship,wrist, vertebral compression fractures
investigation osteoporosis DEXA- measures bone mineral density
drugs causing osteoporosissteroids, heparin, AEDs

Section 3

Question Answer
T scorenumber of SD bone mass density differs from the mean
Z scorecompares your bone mass density to what is normal for someone your age
components of Z scoreZ-score is a comparison of a person's bone density with that of an average person of the same age and sex
pre-op Paget'scross-match as paget's is very vascular

Section 4

Question Answer
management osteoporosisprevention of falls, modifiable RF, bisphosphonates,HRT, SERMS,Denosumab,strontium, Calcitonin
MOA bisphosphonates destroy osteoclast- prevent bone resorption
MOA SERMsprevents bone loss
role of Denosumabreduce osteoclastogensis
MOA strontiumincrease bone density
examples of bisphophonatesetidronate, alendronate
MOA denosumabhuman monoclonal Ab against RANK ligand
example of SERMraloxifene

Section 5

Question Answer
presentation OPbone pain, shrinking, fractures from minor trauma
presentation paget'sbowing legs, deafness , cardiac failure, bone pain, (1/3rd asymptomatic)
investigation paget'sisotope bone scans-increased uptake
investigation ricketslow mineral (Ca, Ph, vit D) + high proteins (ALP, PTH)