Term
| How much of body Ca2+ is stored in bone? |
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Definition
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Term
| What is the affect of PTH & Vit D on serum Ca2+? |
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Definition
| Increase it, therefore decrease bone levels |
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Term
| How much of body's Phosphate is stored in bone? |
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Definition
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Term
| Which 2 minerals is bone the reservoir for? |
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Definition
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Term
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Definition
| Chief cells of parathyroid gland. |
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Term
| What is the action of PTH? |
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Definition
| Stimulates osteoclasts to resorb bone--> increases serum Ca2+ levels |
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Term
| What does Vit D stimulate in the intestines? In the bones? |
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Definition
| Intestines-absorption of Ca2+ & Phosphate; Bones-osteoclastic resorption of bone which incr serum Ca2+ levels |
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Term
| Where is Calcitonin made? |
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Definition
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Term
| What is action of calcitonin? |
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Definition
| Inhibits bone resorption by osteoclasts (decr serum Ca2+), inhibits new bone formation |
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Term
| Which bones are affected by metabolic bone disease? |
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Definition
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Term
| 3 ways net bone mass can be decreased in metabolic bone disease? |
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Definition
| Inadequate production, excessive resorption, inadequate mineralization |
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Term
| How is mineralization affected in osteoporosis? |
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Definition
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Term
| What are the 2 types of primary osteoporosis? |
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Definition
| Type 1 - Postmenopausal, Type 2 - Senile |
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Term
| Name 6 causes of secondary osteoporosis. |
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Definition
| Endocrine disorder, GI disorder, Rheumatologic disorder, drugs, alcohol, smoking |
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Term
| Bone mass is decreased by low estrogen increasing the secretion of cytokines which stimulates osteoclastic activity in which type of osteoporosis? |
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Definition
| Primary Type 1 (Postmenopausal) |
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Term
| Bone mass loss due to old people's osteoblasts not being good at making bone is seen in which type of osteoporosis? |
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Definition
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Term
| Which parts of bone are affected in Type 1 vs Type 2 Primary Osteoporosis? |
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Definition
| Type 1 - Trabecular; Type 2 - Trabecular & Cortical |
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Term
| What gender & ethnicity tend to have higher peak bone mass? |
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Definition
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Term
| What causes primary Hyperparathyroidism? |
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Definition
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Term
| What causes secondary Hyperparathyroidism? |
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Definition
| Renal failure, Vit D deficiency |
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Term
| How much of bone mass has to be lost before osteoporosis is visible via Xray? |
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Definition
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Term
| A defect in bone matrix mineralization due to lack of Vit D is called what? |
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Definition
| Rickets (kids), Osteomalacia (adults) |
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Term
| Problems with which organs can lead to Rickets/Osteomalacia? |
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Definition
| Liver, pancreas, small bowel |
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Term
| Widening of growth plate w flaring of metaphysis due to overgrowth of epiphyseal cartilage w abundant unmineralized bone is seen in which disease of bone metabolism? |
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Definition
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Term
| What is expansion of the costrochondral juncton is called what & which disease is it seen in? |
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Definition
| Rachitic rosary, seen in Rickets |
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Term
| Xray shows prominent osteoid seams in bone in an adult - what metabolic disease of bone are we looking at? |
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Definition
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Term
| What is the result of the increased PTH levels caused by hyperparathyroidism? |
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Definition
| Increased PTH levels are detected by osteoblasts --> release mediators --> stimulate osteoclastic activity |
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Term
| Xray shows subperiostial resorption in fingers & brown tumors - what is it? |
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Definition
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Term
| What causes the brown tumor seen in hyperparathyroidism? |
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Definition
| Excess osteoclast activity |
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Term
| Renal Osteoidystrophy, when chronic renal failure leads to a low level of serum Ca2+ & high level of serum Phosphate, causes stimulation of what? |
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Definition
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Term
| What effect does chronic renal failure have on serum Ca2+ & phosphate levels? |
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Definition
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Term
| How does chronic renal failure impair Ca2+ absorption by the intestines? What does this lead to? |
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Definition
| Decreased ability to convert Vit D to active metabolite--> decr active Vit D--> reduced Ca2+ absorption--> massive activation of PTH |
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Term
| Xray shows Rugby Jersey Spine - what is it? |
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Definition
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Term
| What disease is characterized by marked proliferation of bone cells w abnormal bone remodeling? |
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Definition
| Paget's Disease (Osteoitis Deformans) |
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Term
| Xray shows bone enlarged w thickening of cortices & cancellous bone - what is it? |
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Definition
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Term
| Biopsy shows mosaic pattern of lamellar bone w irregular cement lines, a lot of osteoclasts w intranuclear inclusions, abundant osteoblasts, coarse & thickened trabeculae - what is it? |
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Definition
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Term
| Which metabolic disease of bone is possibly viral in orgin? What virus? |
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Definition
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Term
| Osteogenic sarcoma is a possible complication of which disease? |
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Definition
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Term
| What are the 3 phases of Paget's disease? |
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Definition
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Term
| If RA tends to not cause destructive, erosive disease in the elderly why is it bad? |
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Definition
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Term
| If pt had RA when young which flares up again when old, how are they treated? |
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Definition
| Mixture of drugs to treat various systemic complications |
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Term
| What are the 2 main courses of treatment in an elderly person w RA? |
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Definition
| Palliative (low dose prednisone), or Remittive (chemo instead of roids) |
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Term
| What are the 3 Crystal-Induced Arthropathies seen in older adults? |
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Definition
| Gout (monosodium urate), Pseudogout (calcium pyrophosphate dihydrate), Milwaukee Shoulder (calcium hydroxyapatite) |
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Term
| What is your first priority in an elderly pt presenting w acute, immobilizing gout? |
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Definition
| Mobilize (get 'em walking) |
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Term
| How does pseudogout usually present in the elderly? |
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Definition
| Acute monoarthritis (esp knee) |
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Term
| How does pseudogout usually present in the elderly? |
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Definition
| Acute monoarthritis (ie knee, wrist) |
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Term
| An elderly pt recovering from an acute illness, with diabetes, or w hyperthyroidism develops a "hot wrist" - what disease do we think of? |
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Definition
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Term
| Old woman w diabetes & acute shoulder pain - where is her shoulder from? |
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Definition
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Term
| Elderly male, sudden onset of constitutional symptoms incl polyarthritis, diffuse arthralgia, poly-arthritis, pleuritic chest pain - what do we think? |
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Definition
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Term
| What 2 diseases are seen idiopathic lupus but not drug-induced? |
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Definition
| Glomerular Nephritis & CNS disease |
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Term
| How is Drug-Induced Lupus treated? |
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Definition
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Term
| Procainamide, hydralazine, isoniazad, phenytoin, chlorpromazine, & quinidine are drugs assoc w what disease? |
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Definition
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