Y2 OCaPE: ESR 5 Mrs Gertrude’s Banana Slip – Spine

Fractured vertebrae at T12 (1)

Due to severe compression compared to other vertebrae (1)

What factors put Mrs Gertrude at an increased risk of this pathology?

-Osteoporosis (1)

-as she is around the age of the menopause (1)

Explain the most likely mechanism of her condition

Due to menopause, reduced oestrogen levels, leads to increased bone resorption (1)

Apart from the bone protective effect, name 3 other functions of oestrogen

ANY THREE OF: (3)

•  At low conc of Oestrogen, oestrogen reduces LH and FSH (negative feedback)

• High oestrogen for more than 36 hours, GnRH cells sensitized. Causes release LH and FSH

•  Oestrogen also causes endometrial proliferation (⬆️ Expression of progesterone-R)
• Make cervix secrete HIGH VOLUME, LOW VISCOSITY SECRETIONS (favourable for fertilisation)
•  Metabolic effects -favour protein synthesis (anabolic) & retention of salt and water
• Secondary sexual characteristics
• Maintain normal vascular fuction,
•  Closes epiphyseal growth plate at the end of puberty
• ⬆️ Coagulability of blood
• ⬆️ HDL, lower LDL 🙂

How would you diagnose osteoporosis ?

use a DEXA scan which measures 2D bone density (1)

>2.5 Standard Deviations = osteoporosis (1)

Name 3 drugs and their mechanism of action to treat osteoporosis

Three drugs with correct mechanism of action = 5 marks

2 drugs with correct mechanism = 3 marks

3 drugs with no correct mechanisms = 1.5 

What endocrine condition may lead to increased bone resorption?

-excessive PTH –  hyperparathyroidism –  leads to increased break down of bone (1)

Draw an ECG you would expect to find with this endocrine condition

-hypercalcaemia
-causes short QT wave (2)

What are the missing blanks in this flowchart for Vitamin D?

(3)