Osteoporosis Overview and Causes
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Questions and Answers

Which of these conditions is NOT typically associated with secondary osteoporosis?

  • Hypothyroidism (correct)
  • Hyperparathyroidism
  • Growth hormone deficiency
  • Hyperthyroidism
  • What is the characteristic feature of age-related osteoporosis that differentiates it from post-menopausal osteoporosis?

  • Increased turnover at the bone vascular interface within cortical bone (correct)
  • Decreased turnover at the bone vascular interface within cancellous bone
  • Increased bone breakdown by osteoclasts in the cortical bone
  • Increased bone formation by osteoblasts in the cancellous bone
  • What is a common presenting symptom of osteoporosis?

  • Chronic muscle fatigue
  • Persistent joint stiffness
  • Sudden onset of back pain (correct)
  • Progressive loss of appetite
  • Which of the following medications is NOT commonly associated with an increased risk of osteoporosis?

    <p>Angiotensin-converting enzyme (ACE) inhibitors (B)</p> Signup and view all the answers

    Which of the following is NOT a risk factor for osteoporosis that contributes to the calculation of the FRAX score?

    <p>Diabetes mellitus (B)</p> Signup and view all the answers

    What is the most common type of fracture associated with osteoporosis?

    <p>Vertebral compression fracture (C)</p> Signup and view all the answers

    What is the primary mechanism by which osteoporosis develops?

    <p>Increased bone resorption by osteoclasts and decreased bone formation by osteoblasts (C)</p> Signup and view all the answers

    Which of the following genes is NOT known to be associated with an increased risk of osteoporosis?

    <p>Fibroblast growth factor 23 (FGF23) (A)</p> Signup and view all the answers

    Flashcards

    Osteoporosis

    A progressive bone disease with reduced bone density and increased fracture risk.

    Causes of Osteoporosis

    Increased bone breakdown by osteoclasts and decreased formation by osteoblasts.

    Primary Osteoporosis

    Osteoporosis not due to another medical condition, includes post-menopausal and age-related types.

    Post-menopausal Osteoporosis

    Type of primary osteoporosis; loss of bone resistance following menopause.

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    Secondary Osteoporosis

    Osteoporosis resulting from other medical conditions or medications.

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    Risk Factors - FRAX Score

    10-year fracture risk assessment tool based on age, gender, and health factors.

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    Common Fractures in Osteoporosis

    Most common fractures occur in vertebrae, often leading to acute back pain.

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    Presentation of Osteoporosis

    Asymptomatic until fractures occur, often presenting with pain from fragility fractures.

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    Study Notes

    Osteoporosis Overview

    • Osteoporosis is a progressive bone disease increasing fragility fracture risk.
    • Characterized by reduced bone mineral density and microarchitectural defects.
    • More prevalent in women, Caucasians, and Asians.

    Causes of Osteoporosis

    • Bone Turnover Imbalance: Increased osteoclast activity (bone breakdown) and reduced osteoblast activity (bone formation) lead to bone mass loss.
    • Genetics: Genes like collagen type 1A1, vitamin D receptor, and estrogen receptor genes play a role.

    Types of Osteoporosis

    • Primary Osteoporosis:
      • Post-Menopausal Osteoporosis: Increased remodeling units, premature osteoblast cessation, and trabecular perforation contribute to fracture susceptibility.
      • Age-Related Osteoporosis: Increased bone turnover at the cortical bone vascular interface weakens long bone structure.
    • Secondary Osteoporosis: Various conditions contribute:
      • Endocrine Disorders: Hyperthyroidism, hyperparathyroidism, growth hormone deficiency, Cushing's syndrome.
      • Metabolic Conditions: Diabetes, malabsorption (IBD, coeliac, chronic pancreatitis, gastrectomy), chronic kidney disease (CKD), chronic liver disease, COPD, sickle cell anaemia.
      • Other Factors: Osteogenesis imperfecta, homocystinuria, alcohol abuse, hypogonadism (Turner's syndrome, testosterone deficiency), immobilisation.
      • Medications: Prolonged glucocorticoid use (e.g., prednisolone), selective serotonin reuptake inhibitors (SSRIs), antiepileptics, proton pump inhibitors (PPIs), glitazones, long-term heparin therapy, aromatase inhibitors (e.g., anastrozole), Carbamazepine, anti-oestrogens.

    Risk Factors and Assessment

    • FRAX Score: Used to estimate the 10-year probability of fracture.
    • Indications for FRAX: Women aged 65+ or men aged 75+, or younger individuals with certain risk factors.
    • FRAX Components: age, sex, previous fracture history, parental history of hip fracture, low body mass index (BMI), smoking, glucocorticoid use, rheumatoid arthritis, secondary osteoporosis, and alcohol consumption.

    Presentation of Osteoporosis

    • Asymptomatic Stage: Typically asymptomatic until fractures occur.
    • Fractures:
      • Vertebral Compression Fractures: Acute back pain, restricted spinal movement, intensified pain with weight bearing, thoracic kyphosis (dowager's hump).
      • Appendicular Fractures (e.g., hip, distal radius): Pain, inability to bear weight, shortened/externally rotated leg (hip), wrist pain, reduced movement, dinner-fork deformity (Colles fracture).
      • Other Fractures: Humerus, pelvis.

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    Description

    This quiz covers the key aspects of osteoporosis, including its definition, causes, and types. You will learn about the bone turnover imbalance and the genetic factors that contribute to this disease. Gain insights into primary and secondary osteoporosis to better understand its implications.

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