57 Questions
Which of the following is not a metabolic and endocrine bone disorder discussed in the lecture?
Sarcopenia
Which condition is characterized by tumor secretion of parathyroid hormone-related peptide (PTHrP)?
Humoral hypercalcemia of malignancy
What is the cause of Paget’s Disease/ Osteitis Deformans?
Unknown (genetic/environmental factors)
Which condition involves dysregulated bone remodeling at the microscopic level?
Paget’s Disease/ Osteitis Deformans
According to the information provided, which bone disorder is associated with a decrease in both vertebral body and disc volume as bone mineral density (BMD) decreases?
Osteoporosis
Which condition is characterized by autonomous production of calcitriol by lymphoma cells?
Calcitriol-mediated hypercalcemia
Which type of hypercalcemia is very rare and characterized by tumor production of parathyroid hormone?
Ectopic hyperparathyroidism
Which of the following is a symptom of hypocalcaemia?
Numbness
What is a common cause of hypercalcaemia?
Cancer
Which region has a high prevalence of rickets?
Middle East
What is a potential cause of rickets?
Vitamin D deficiency
What is osteomalacia?
Inadequate bone mineralization due to vitamin D or phosphate deficiency
What is the prevalence of osteoporosis in Hong Kong among women aged 50 or above according to JOCOC in 2008?
1 in 3
What is the mortality rate associated with osteoporotic fractures?
20%
What is the projected percentage of Hong Kong's aging population in 2050?
39%
What is the effect of aging on metabolism and sex hormones?
Decreases metabolism and sex hormones
What are the recommended weight-bearing exercises for osteoporosis patients?
Walking, brisk walking, and Tai Chi
At what age does muscle loss onset typically begin in Whites?
Mid to late 20s
What are the symptoms of sarcopenia?
Loss of lean muscle mass, reduced strength, functional decline, and increased risk of falling
What is the best intervention for sarcopenia?
Exercise, with progressive resistance training showing positive effects
What is the prevalence of sarcopenia in 60-70 year olds?
5-13%
What contributes to sarcopenia?
Changes in hormones, immobility, age-related muscle changes, nutrition, and neurodegenerative changes
Which metabolic bone disorder is characterized by skeletal hypomineralization and respiratory compromise?
Hypophosphatasia
What is the characteristic biochemical finding in the diagnosis of hypophosphatasia?
Low serum alkaline phosphatase
Which metabolic bone disorder is commonly caused by parathyroid adenoma?
Hyperparathyroidism
What is the characteristic abnormality in bone turnover in Chronic Kidney Disease Mineral Bone Disorder (CKD-MBD)?
Elevated alkaline phosphatase
What is the common cause of secondary hyperparathyroidism?
Vitamin D deficiency
What is the characteristic abnormality in bone turnover in Chronic Kidney Disease Mineral Bone Disorder (CKD-MBD)?
Decreased serum calcium and increased serum phosphorus levels
What is the prevalence of osteoporosis in Hong Kong among women aged 50 or above according to JOCOC in 2008?
20%
What is the common cause of secondary hyperparathyroidism?
High phosphorus levels
What is a potential cause of rickets?
High serum phosphate levels
What is the effect of aging on metabolism and sex hormones?
Decreased metabolism and decreased sex hormone production
Which type of hypercalcemia is characterized by autonomous production of calcitriol by lymphoma cells?
Calcitriol-mediated hypercalcemia
Which condition involves dysregulated bone remodeling at the microscopic level, specifically excessive bone breakdown and subsequent disorganized new bone formation?
Paget’s Disease/ Osteitis Deformans
Which metabolic bone disorder is characterized by cellular remodeling and deformity of one or more bones, with unknown cause (genetic/environmental factors)?
Paget’s Disease/ Osteitis Deformans
Which type of hypercalcemia is characterized by tumor production of parathyroid hormone and is very rare?
Ectopic hyperparathyroidism
Which type of hypercalcemia is characterized by local release of factors, including PTHrP, by bony metastases that promote osteoclast differentiation and function?
Local osteolytic hypercalcemia
Which metabolic bone disorder is characterized by dental findings, low serum alkaline phosphatase, and gene mutation analysis?
Hypophosphatasia
What is the characteristic abnormality in bone turnover in Chronic Kidney Disease Mineral Bone Disorder (CKD-MBD)?
Elevated parathyroid hormone
What is the common cause of secondary hyperparathyroidism?
Vitamin D deficiency
What is the primary cause of hypercalcaemia in 20% to 30% of cancer patients?
Malignancy
What is the treatment for primary hyperparathyroidism?
Removing the adenoma
What is the projected increase in Hong Kong's aging population from 2009 to 2050?
What is the prevalence of osteoporosis in Hong Kong among men aged 50 or above according to NOF in 2022?
1 in 4
What is the mortality rate associated with osteoporotic fractures?
20%
What are the consequences of osteoporotic fractures?
Mortality rate of 20%, permanent disability rate of 30%
What is the recommended weight-bearing exercise for osteoporosis patients according to the provided text?
Brisk walking
What is the prevalence of sarcopenia in those over 80 years old?
11-50%
At what age does muscle loss onset typically begin in Asians?
Around age 30
What is the best intervention for sarcopenia according to the text?
Exercise
What contributes to sarcopenia according to the text?
Changes in hormones
What are the symptoms of sarcopenia according to the text?
Loss of lean muscle mass, reduced strength, functional decline, and increased risk of falling
What is the primary cause of hypocalcaemia?
Hypoparathyroidism
Which type of rickets is associated with skeletal hypomineralization and respiratory compromise?
Osteomalacia
What is the most common cause of hypercalcaemia?
Primary hyperparathyroidism
Which of the following is a symptom of hypercalcaemia?
Confusion
What is the primary cause of rickets in children in the Middle East, Africa, and Asia?
Lack of sun exposure
Study Notes
Metabolic Bone Disorders: Osteomalacia, Hypophosphatasia, CKD-MBD, Hyperparathyroidism
- Osteomalacia is caused by vitamin D deficiency or faulty metabolism and can lead to bone deformities and pathologic fractures.
- Diagnosis of osteomalacia involves biochemical findings similar to rickets, low vitamin D concentration, low serum calcium, low serum phosphate, elevated alkaline phosphatase, and parathyroid hormone.
- Hypophosphatasia is a rare metabolic bone disease with perinatal and childhood variants characterized by skeletal hypomineralization and respiratory compromise.
- Diagnosis of hypophosphatasia involves dental findings, low serum alkaline phosphatase, and gene mutation analysis.
- Treatment of hypophosphatasia includes maintaining calcium balance, physical, dental, and orthopedic interventions, and in some cases, enzyme replacement therapy.
- Chronic Kidney Disease Mineral Bone Disorder (CKD-MBD) is characterized by abnormal metabolism of calcium, phosphorus, parathyroid hormone, and abnormalities in bone turnover.
- CKD-MBD leads to uremic vascular calcification and osteoporosis, and treatment involves nutritional vitamin D supplementation.
- Hyperparathyroidism is characterized by elevated blood calcium and parathyroid hormone levels, with primary hyperparathyroidism commonly caused by parathyroid adenoma.
- Secondary hyperparathyroidism is often due to vitamin D deficiency or chronic kidney disease.
- Hypercalcaemia occurs in 20% to 30% of cancer patients and is associated with malignancy.
- Primary hyperparathyroidism is often cured by removing the adenoma or using cinacalcet to decrease PTH levels.
- Secondary hyperparathyroidism is common in chronic kidney disease and requires treatment of the underlying condition and sometimes vitamin D supplementation.
Clinical Research on Calcium Disorders and Rickets
- Clinical research focuses on sarcopenia mechanisms, epidemiology, diagnostic criteria, and therapeutic approaches
- New pharmaceutical therapies in development include myostatin and selective androgen receptor modulators (SARMs)
- Hypercalcaemia is relatively common, occurring in about 2.7% of cancer patients
- Symptoms of hypercalcaemia range from abdominal pain to abnormal heart rhythm
- Causes of hypercalcaemia include primary hyperparathyroidism, cancer, and other conditions
- Hypocalcaemia symptoms include numbness, muscle spasms, confusion, and cardiac arrest
- Causes of hypocalcaemia include hypoparathyroidism, vitamin D deficiency, and other medical conditions and medications
- Rickets is common in the Middle East, Africa, and Asia, affecting children aged 3 to 18 months
- Rickets is caused by vitamin D deficiency, dark skin, and lack of sun exposure
- Rickets symptoms include bowed legs, stunted growth, bone pain, and other complications
- Various types of rickets exist, including vitamin D-related, hypophosphatemia-related, and congenital forms
- Osteomalacia, a milder adult form of rickets, is caused by inadequate bone mineralization due to vitamin D or phosphate deficiency
Test your knowledge of metabolic bone disorders such as osteomalacia, hypophosphatasia, CKD-MBD, and hyperparathyroidism. Explore the causes, symptoms, diagnosis, and treatment options for these conditions affecting bone health.
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