How might you increase heart contractility?
Sympathetic activation
+ ionotropic drugs
From what at osteoclasts derived?
Macs; osteocytes = giant cells!
Osteoblasts:
Describe their life cycle
How do they communicate?
Osteoblasts –> become CYTES and live in lacunae
Communicate via the canaliculi
Basic pathogenesis of osteoporosis + causes/risks
Osteoclasts»_space;> osteoblasts
- menopause (low estrogen)
- steroid use
- loop diuretics
- low vitamin D/Ca intake
- alcohol/ smoking/lack of exercise
*** but not necessarily obesity. Low weight women are actually at higher risk. So you can basically either have diabetes or osteoporosis when you get old. Your choice. But you cannot win. 😂)
Where is the femoral vein in relationship to the artery.
NAVL.
All of first year, I told myself: L means Lick the Penis. The penis is medial. L is medial. So NAVL goes Lat –> Med.
The femoral vein is MEDIAL to the femoral artery.
Three more common treatments for osteoporosis
- vitamin D/Ca supplements
- bisphosphonates to inhibits clasts (–“dronates”)
- Teriparatide (recombinant PTH) but only for up to two years
Two strange ADRs of bisphosphonates
- Errosive esophagus
- necrosis of the jaw; esp after procedures
Why ISNT estrogen used to treat osteoporosis?
Because it increases risk of MI/CVA
Other than bisphosphonates, what is a less commonly used osteoclast inhibitor?
Denosumab
“OSTEOCLASTS! YOU BREAKIN MY BONES? Ok, DEN. You gonna get jumped by the MOB. (Mab))!!! And not even RANKL will save you!!”
Blocks RANKL
What is deficient in osteoPETROSIS?
What are some classic findings?
Labs?
Carbonic anhydrase 2 in osteoCLASTS
- erlenmyer flask deformity
- CN entrapment
- pancytopenia (cause the marrow area is smashed up full of bone)
- failure normal labs
- essentially normal labs
Pagets:
Pathogenesis
Some classic findings
Labs?
Osteoclasts go crazy breaking things; then blasts come in and fix the fractures all strange. Get LOTS of DISORDERED bone production.
- grass blade fracture
- “increased hat size” (skull size)
- hearing trouble (narrowed auditory foramina
Labs are relatively normal
Osteomalacia- same as?
Classic findings?
Labs?
Ricketts; vitamin D deficiency –> Ca deficiency
- get BOWED LEGS; “soft poorly mineralized bones”
- low Ca –> high PTH –> low phosphate
Polyostotic dysplasia:
May be part of what disease?
Pathogenesis?
Bone replaced by collagen and fibroblasts to get irregular trabeculae
May be part of McCune Albright
Three McCune Albright findings
Precious puberty, cafe au lait, fibrous dysplasia
Von RECKLINGHAUSEN!!!
- other less cool name
- pathogenesis
- findings
Osteitis fibrosa cystica
Endocrine disorder: HYPERparathyroid; pseudohypoparathyroid
Causes ^^ PTH; = bone breakdown.
Get: “brown tumors” & low bone density
What is pseudohypoparathyroid?
Renal tubule resistance to PTH; body pumps out MORE PTH as a result
Lab findings assc with osteitis fibrosa cystica?
^PTH and Ca; decreased phosphate
Bone enlargement, pain and arthritis are assc with?
Lecture says Pagets; don’t know why this couldn’t also be osteopetrosis
Vertebral compression fractures should make you think of?
Osteoporosis
