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Terms in this set (26)
Osteocalcin is measurable in serum as a sensitive marker for what?
Receptor activator for nuclear factor = increased osteoclast activity. Osteoprotegerin blocks RANK activity. RANK ligand is on ostoblast, RANK receptor is on osteoclast precursor.
Woven bone in adults is always...
Woven bone has more...
Lamellar bone has less...
Which is stress oriented: lamellar or woven bone?
Causes of primary osteoporosis
Causes of secondary osteoporosis
Rheumatoid arthritis, SLE
Anticoagulants, Corticosteroids, alcohol
Osteogenesis imperfecta, immobilization
What is the average bone loss/year?
Post-menopausal bone loss
2%/year cortical bone, 9%/year cancellous bone
Type of Vitamin D receptor. Accounts for approximately 75% maximal peak bone mass achieved
Factors in menopause that contribute to osteoporosis
- Decreased serum estrogen
- Increased IL-1, IL-6, TNF levels
- Increased RANK, RANKL expression
- Increased osteoclast activity
Factors of aging that contribute to osteoporosis
- Osteoblasts - reduced reproductive and biosynthetic potential with increasing age
- Decreased biologic activity of matrix-bound growth factors
- Reduced physical activity - increases rate of bone loss. Exercise acts as stimulus for bone remodeling. Weight training better than running because load magnitude impacts on bone density more than the number of lead cycles.
A decreased amount of estrogen in post-menopausal women leads to...
A decrease in bone mass
Osteoporosis incidence in women
50% of women will have postmenopausal osteoporosis fractures, due to loss of 35-50% of their bone mass
Osteoporosis mainly affects what kind of bone?
Cancellous bone (senile osteoporosis leans to cortical bone loss)
Tx for osteoporosis. Selectively decrease osteoclast-mediated bone resorption
Characteristics of rickets in kids
Lumbar lordosis and bowing of the legs
How do the skeletal abnormalities of secondary versus primary hyperparathyroidism compare?
Skeletal abnormalities of secondary hyperparathyroidism are milder than the primary form because secondary is generally not as severe and prolonged
When calcium increases, what happens to phosphate?
Roles of PTH
- Increases synthesis of Vit D -> Increase Ca++ reabsorption
- Stimulates resorption of Ca++ from kidney tubules
- Stimulates osteoblasts
- Leads to increased RANK, which stimulates osteoclast activation and calcium reabsorption from the gut
Which is more common: Metastatic lesions or primary bone tumors?
Most common neoplasms metastasizing to bone in descending order
Prostate (usually osteoblastic)
Most metastases are...
Osteolytic (tumor cells secrete PTHRH, prostaglandins or interleukins that stimulate osteoclast bone resorption)
Primary lesions: age and location
Osteosarcoma-teens, metaphysis knee
Chondrosarcoma-adults, trunk, limb girdles, proximal long bones
Giant cell tumors-epiphysis long bones
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