Musculoskeletal - Metabolic Bone Diseases
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- What are the definition of osteoporosis?
- Decreased synthesis or increased resorption of bony matrix protein. Results in fractures particularly of hip and spine leading to kyphosis.
- What are risk factors for osteoporosis?
- Postmenopause (low estrogen), sedentary, high cortisol, hyperthyroid, calcium deficiency
- What can you give to help slow osteoporosis?
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1) Estrogen: slows loss, builds density
2) Calcitonin: slows loss, analgesic
3) Bisphosphonates (Pamidronate, Alendronate): increase bone density
4) Calcium supplements: 1 gram/day - What is Osteitis Fibrosa Cystica (von Recklinghausen's)?
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1) Hyperparathyroid --> diffuse lytic lesions
2) "Brown tumor" of bone due to cyst hemorrhage
3) Can mimic osteoporosis on x-ray - What is Osteomalacia?
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1) Adult vitamin D deficiency leading to defective calcification of osteoid matrix
2) X-ray mimic osteoporosis
3) Called "renal osteodystrophy" if secondary to kidney disease - What is Rickets?
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1) Vitamin D deficiency in kids causing epiphyseal plate thicking
2) Multiple skeletal defects, short stature - What is Scurvy?
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1) Vitamin C deficiency causes impaired osteoid formation (cannot hydroxylate lysine/proline of preprocollagen)
2) Bleeding gums, osteoporosis, ecchymoses - What is overactive in Paget's Bone Disease (Osteitis Deformans)?
- Increased activity of BOTH osteoblasts & osteoclasts.
- Who gets Paget's Bone Disease? Which bones does it usually affect?
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1) Mostly elderly, may be of paramyxovirus etiology?
2) Spine, pelvis, skull, femur, tibia - What are the 3 phases of Paget's Bone Disease?
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1) Osteolytic: mostly osteoclast activity
2) Mixed: see MOSAIC pattern of blue cement lines
3) Osteoblastic: inc. bone density - What are the complications of Paget's Bone Disease?
- Osteosarcoma, high output cardiac failure, fractures/pain, hearing loss.