Minerals & Symptoms
Constipation, acute renal failure, short QT interval
Hypercalcemia
It is the 2nd most common bone disease. Osteoporosis is the 1st.
Paget's Disease
It is the gold standard for detection of BMD (bone mineral density).
DEXA Scan
MOA of bisphosphonates.
Inhibition of osteoclast resorption.
This fast food chain used to sell pizza.
McDonald's
*They sold pizza from the late '80s to early '90s
Skeletal muscle contractions & weakness
*Bonus Points if you can name the 2 signs associated with this mineral abnormality
Hypocalcemia
It is the mechanism by which renal osteodystrophy occurs.
Secondary hyperparathyroidism secondary to chronic renal failure.
*High PTH/ Low Ca2+/High Phosphate/Low 1,25(OH) 2 d
Secondary hyperparathyroidism also may occur as a result of defective renal production of 1,25(OH) 2 d combined with an increased serum phosphate concentration and calcium-phosphate precipitation into soft tissues (see Chapters 72 and 73 ). This circumstance evokes a marked increase in PTH secretion that causes significant increases in bone turnover, demineralization, and fracture. These patients may respond dramatically to oral or parenteral replacement of 1,25(OH) 2 d or the calcium receptor mimetic cinacalcet, or both.
Osteoporosis is "silent" until this occurs.
Fracture
2 of the 3 criteria for beginning osteoporosis treatment.
1. An adult hip or vertebral fragility fracture
2. Osteoporosis by DEXA T-score ≤ −2.5 SD for lumbar spine, total hip, or femoral neck after appropriate evaluation
3. Low bone mass by DEXA T-scores between −1.0 and −2.5 SD at the lumbar spine or femoral neck and a WHO FRAX 10-year probability of a hip fracture ≥3% or a 10-year probability of major osteoporosis-related fractures ≥20% based on a WHO algorithm
*fracture risk assessment tool
The year wherein the Bikini was made.
Bonus Points if you know where the name bikini came from.
1946
* Rationing was in & Bikini Atoll just happened to be where post-war atomic bomb testing occurred.
Tumor Lysis Syndrome or Rhabdomyolysis can cause this mineral abnormality
Hyperphosphatemia
Looser's Zones can be seen radiographically in these diseases.
Rickets or Osteomalacia
It is the maximum dose of Calcium Carbonate or Calcium Citrate recommended for osteoporosis prevention.
1200 mg
*Calcium Carbonate needs to be taken with meals for better absorption
Antibody to RANKL
*Bonus Points if you can state what RANKL stands for
Denosumab
*Receptor activator of nuclear factor kappa-Β ligand
He said, "There’s Only One God … And He Doesn’t Dress Like that" in __________ (movie).
Captain America in The Avengers
Name at least 2 reasons for hypocalcemia (Cecil's lists 5).
1. A reduction in serum binding proteins (e.g., albumin)
2. An increase in renal calcium excretion
3. A reduction in intestinal calcium absorption
4. An increase in serum phosphate with a resultant increase in the calcium-phosphate solubility product
5. A loss of calcium from the ECF into the skeleton.
It is the difference between secondary & tertiary hyperparathyroidism.
Secondary hyperparathyroidism is an appropriate increase in PTH levels caused by malabsorption, vitamin D deficiency, or chronic renal failure. Calcium levels are normal or subnormal.
Tertiary hyperparathyroidism refers to elevated PTH resulting from long-standing stimulation of the parathyroid glands along with hypercalcemia, as in the setting of renal failure (see Chapter 73 ). Chronic stimulation results in hyperplasia or adenomas.
It is the range of bone marrow density for osteopenia.
Between −1.0 and −2.5 SD of young adult peak mean value
The SERM indicated for osteoporosis prevention & treatment.
Raloxifene
Seafood Salad was sold at this fast food restaurant in 1986.
Taco Bell
Hyporeflexia, drowsiness, and hypocalcemia in the context of lifesaving measures
*Bonus Points if you can name the condition needing lifesaving measures
Hypermagnesemia
Name 2 bone marrow diseases that subsequently cause bone marrow demineralization.
Hint: Crab
Multiple myeloma or Waldenström's macroglobulinemia
The percentage of bone loss required for radiographic detection.
30%
An osteoanabolic agent used with men who have a high fracture risk, as well as postmenopausal women. It increases BMD & reduces fractures.
Teriparatide (recombinant PTH)
"A baby's gotta do what a baby's gotta do" is a line from this 90's cartoon.
Rugrats