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Flashcards in Metabolic Bone Disease Deck (19)
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1
Q

What cells create pre-osteoclasts?

A

Myeloid progenitor cell

2
Q

What cells make pre-osteoblasts?

A

Mesenchymal progenitor cell

3
Q

Factors that stimulate osteoblasts expression of RANK ligand?

A

PGE2, PTH, glucocorticoids, vitamin D, IL-11, IL-1, PTHrP, TNF-a

4
Q

What is Paget’s disease of the bone?

A

Localised disorder of bone turnover, there is increased bone resorption followed by increased bone formation

5
Q

What does the disorder of bone turnover in Paget’s disease lead to?

A

Disorganised bone that is bigger, less compact, more vascular and more susceptible to deformity and fracture

6
Q

Does Paget’s disease have a genetic or environmental trigger?

A

Genetic component- Loci of SQSTMI

Environmental trigger- ?chronic viral infection within the osteoclasts

7
Q

Symptoms of Paget’s disease?

A
Bone pain, 
Bone deformity or fracture,
Local heat, 
Neurological complications eg hearing loss,
Osteosarcoma ?
8
Q

Sign of Paget’s disease?

A

Local heat,
Bone deformity or fracture,
Isolated elevation of serum alkaline phosphatase

9
Q

Should you treat asymptomatic Paget’s disease?

A

Not unless in skull or in area requiring surgical intervention

10
Q

treatment of symptomatic Paget’s disease?

A

Intravenous Bisphosphonates therapy,

One off IV zoledronic acid

11
Q

What deficiency causes rickets and osteomalacia?

A

Vitamin D or Calcium

12
Q

Rickets signs?

A
Wide bones, 
Wide ankles, 
Odd-shaped legs, 
Large abdomen, 
Wide joints at elbow and wrist,
Odd shaped ribs and breast bones, 
Odd curve to spine or back,
Large forehead, 
Stunted growth
13
Q

Osteomalacia signs?

A

Bone pain and tenderness, fractures

14
Q

Define osteogenesis imperfecta

A

Genetic disorder of connective tissue, causing fragile bones

15
Q

Osteogenesis imperfecta pathology

A

Defects in type 1 collagen

16
Q

The first 4 types of osteogenesis imperfecta?

A

Type 1- milder, child can walk so presents in adults,

Type 2- lethal by age 1

Type 3- progressive deforming with sever bone dysplasia and poor growth

Type 4- similar to type 1 but more severe

17
Q

Signs/ symptoms of osteogenesis imperfecta

A
Fragile bones, 
Growth deficiency,
Defective tooth formation (dentigenesis imperfecta), 
Hearing loss, 
Blue sclera, 
Scoliosis, 
Barrel chest, 
Ligamentous laxity, 
Easy bruising
18
Q

Osteogenesis imperfecta investigations

A

Examination,

The Beighton score

19
Q

Management of Osteogenesis Imperfecta

A

Surgical (for fractures),
IV bisphosphonates,
Genetic counselling,
Social adaptations