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58 Cards in this Set
- Front
- Back
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Name some of the metabolic bone disease? |
Hyperparathyroidism Hypoparathyroidism Osteomalacia Osteoporosis Pagets disease |
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Function of osteoblasts |
Form bone. Bone builders |
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Function of osteocytes |
Transform osteoblasts. |
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Define osteoclasts |
Bone reabsorption. |
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How often the bone remodels? |
5 years |
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What is the function of calcitonin? |
Lowers plasma calcium concentration by inhibiting osteoclastic bone reabsorption activity. Also decreases formation of vitamin D. Calcitonin does the opposite of parathyroid hormone. |
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Types of hyperparathyrodism? |
Primary and secondary |
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What is the difference between primary and secondary hyperparathyrodism ? |
They both have increase parathyroid.
Primary: this happens when there is a problem with at least one of the parathyroid glands. there is an increased absorption of calcium from bones.
Secondary: this type occurs when there is an underlying condition that causes calcium levels to be low. Most common condition is chronic kidney failure. |
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Causes of primary hyperparathyrodism ? |
Benign adenoma (tumor) Genetic Endocrine disorder Hypertension / insulin resistance |
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Causes of secondary hyperparathyrodism ? |
Chronic renal failure Malabsorption syndrome Vit D deficiency Osteomalacia Ricket |
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Signs and symptoms of hyperparathyrodism ? ** |
Renal stones so DRINK FLUIDS constipation Fatigue Weakness Pancreatitis Psych disturbances Abdominal groans |
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Diagnostic tests for hyperparathyrodism ? |
Serum calcium more than 10 mg/dl Increase PTH Increased urine calcium Decreased in bone density |
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Diagnostic tests for hyperparathyrodism ?
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Treatment of hyperparathyrodism ? ** |
Conservative : Hydration 3000 ml/day Encourage salt intake Bone density test Calcimimetic medications
Surgical: Removal of parathyroid glands Removal of adenoma |
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If pt had complete parathyrodectomy, what do we need to check? |
Calcium. Pt will have hypocalcemia. |
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In hypoparathyrodism, pt is low in secretion of parathyroid, therefore low in... |
Calcium |
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What is the function of parathyroid glands? |
It acts to increase the concentration of calcium in the blood. It enhances the release of calcium from large reservoir contained in the bones. |
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Causes of hypoparathyrodism ? |
Acute or chronic. It's is an uncommon hormone deficiency. Usually is Because of disease, injury, or congenital malfunction of parathyroid glands. |
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Signs and symptoms of hypoparathyrodism ? |
Twitches, cramps because of hypocalcemia Positive chvosteks sign Positive trousseaus phenomenon Mood disorders Dementia Seizures CHF Prolonged QT and ST interval Tachycardia Hyperactive bowel sounds Brittle nails and hair Increase deep tendon reflexes Parkinson's like symptoms |
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What tests are done to confirm hypoparathyrodism ? |
Low calcium Low phosphorus Low PTH Low vit D Low urinary output |
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Why do I have to take vitamin D and calcium together? |
Vitamin D pushes calcium |
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How is consider an acute hypoparathyrodism and what med should be given? |
It's a MEDICAL EMERGENCY!!! Give iv calcium gluconate/chloride STAT. |
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What is the long term clinical management / maintenance to treat chronic hypoparathyrodism ? ** |
Lifelong vitamin D therapy Lifelong calcium supplement 1-3 gms/day Muscle relaxants to control muscle spasms Drugs to decrease the GI absorption of phosphorus |
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Which one looks more dangerous hypoparathyrodism or hyperparathyrodism ? |
Hypo |
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What is osteomalacia ? |
A disease in which the bone become abnormally soft due to decrease mineralization of osteoid in compact and spongy bone. Also called "soft bones or adult rickets" |
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What is osteomalacia ? |
A disease in which the bone become abnormally soft due to decrease mineralization of osteoid in compact and spongy bone. |
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Another name for osteomalacia? |
Soft bones / adult rickets |
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Causes of osteomalacia ? |
Malabsorption syndrome Vitamin D deficiency Hypo-phosphatesemia |
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Who is at risk or what population gets osteomalacia ? |
More in women Increase risk of people malnourished, no sun exposure Rare in us due to fortified foods More common in orient, United Kingdom , middle eastern Occasionally in strict vegetarians Occasionally in post-gastrectomy because there is inadequate absorption of vit D and calcium |
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Signs and symptoms of osteomalacia ? |
Pain with ambulation Muscular weakness Generalize malaise |
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What would I see when I do a physical examination of someone with osteomalacia ? |
Scoliosis / kyphosis Deformities of weight bearing bones Waddling gait |
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What would the tests show in a person with osteomalacia ? |
Low calcium Low phosphorus Low vit D Increase alkaline phosphatase |
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What is the medical management of osteomalacia ? |
Correcting calcium / phosphorus ( calcitrol, phosphate supplement) Vit D therapy (IV or oral) Exposure to sunlight |
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What would be the surgical intervention for people with osteomalacia ? |
Orthopedic to correct of long bone deformities Kyphoplasty for compression fractures of the spine |
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Define osteoporosis ? |
The rate of bone reabsorption is more rapid than the rate of bone formation. It's the most common metabolic bone disease |
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What hormones play a role in osteoporosis ? |
Estrogen : decrease in estrogen, decrease in bone density. Up to 20% bone loss in the first 5 years of menopause. Decrease osteoblasts activity and increase in osteoclast activity. |
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Before osteoporosis , I get... |
Osteopenia |
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Where is the normal bone mineral density in the t-score or mean? Where is osteopenia ? Osteoporosis ? Test question |
Normal : a t-score lies between +1 and -1 Osteopenia : (low bone mass) lies between -1 and -2.5 Osteoporosis : lies >-2.5 |
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What are the risk factors of osteoporosis ? |
Gender Age Ethnicity Gynecological considerations Genetics Medical conditions: RA, thyroid, liver disease, spinal cord injury. |
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What are some modifiable risk factors for osteoporosis? |
Sedentary life style Alcohol use Nutritional status: calcium, vit D deficiency Smoking |
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Signs and symptoms of osteoporosis ? |
Kyphosis or hump Fractures Shortened stature Difficulty bending over Occasional impaired breathing due to deformities of spinal and rib cage |
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How do you diagnose osteoporosis ? |
Bone mineral density is -2.5 Laboratory tests: Urinary calcium is high Radiography Bone biopsy |
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Define Paget's disease? |
Slowly progressive metabolic bone disease characterized by initial phase of excessive bone reabsorption followed by a reactive phase of excessive abnormal bone formation.
Have a lot of bone but not good bone. |
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What do I find in Paget's ? ** |
May be asymptomatic Persistent and severe bone pain, especially with weight bearing Kyphosis CHF "Hearing loss" |
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What is the conservative and surgical treatment for Paget's disease? |
Medications NSAIDS, aspirin, calcitonin, didronel, which retard bone absorption Assistive devices Surgery to correct realignment of long bones, or total joint replacement |
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Function of thyroid |
Secretes calcitonin |
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Function of calcitonin |
Opposite of parathyroid. It's lowers the concentration of calcium in the blood. |
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Function of ovaries |
Secretes hormone estrogen which plays vital role in lower loss bone in women |
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Function of testes |
Secretes testosterone which increase size and strength of bones |
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For a person with osteoporosis , how much calcium should be? |
1000-1200 mg/day |
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What are biphosphates? |
Are non-hormonal high selective osteoclast inhibitors. Used for the treatment and prevention of osteoporosis. |
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Examples of biphosphates medications? |
Fosamax, boniva, actonel |
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What is the most important hormone to regulate serum calcium? |
Parathyroid gland. Parathyroid hormone increases the blood calcium level. It enhances the release of calcium from the large reservoir contained in the bones. Also increases the production of activated vitamin D. |
