44. Osteoporosis Flashcards
(18 cards)
What is osteoporosis?
Osteoporosis is decreased bone mass or quality that causes increased bone fragility and fracture risk.
What defines osteoporosis in terms of bone mineral density?
In osteoporosis, the bone mineral density is at least 2.5 standard deviations below that of young, normal individuals.
Who are the most affected individuals by osteoporosis?
Most osteoporotic patients are postmenopausal women and elderly men.
What are the primary causes of osteoporosis?
Osteoporosis is usually due to failure to attain optimal bone mass before age 30 or due to a higher rate of bone resorption than bone formation.
What are the two types of primary osteoporosis?
Type I (postmenopausal) and Type II (over 70).
What characterizes Type I osteoporosis?
Type I osteoporosis involves excess loss of trabecular bone, with common vertebral compression fractures.
What characterizes Type II osteoporosis?
Type II osteoporosis involves equal loss of both cortical and trabecular bone, with common fractures of the femoral neck, proximal humerus, and pelvis.
What is secondary osteoporosis?
Secondary osteoporosis occurs when an obvious cause is present, such as excess steroid therapy or Cushing syndrome.
What are some risk factors for osteoporosis?
Risk factors include estrogen depletion, female gender, calcium and vitamin D deficiency, family history, immobilization, smoking, alcohol, and certain medications.
What are common clinical manifestations of osteoporosis?
Common clinical manifestations include vertebral body compression, hip fractures, distal radius fractures (Colle), and increased incidence of long bone fractures.
What is the gold standard for diagnosing osteoporosis?
The gold standard for diagnosing osteoporosis is a DEXA (dual-energy x-ray absorptiometry) scan.
What are the bone mineral density measurements for osteoporosis?
Normal: 1.0, Osteopenia: -1 to -2.5, Osteoporosis: -2.5 or less, Severe osteoporosis: -2.5 or less with a fragility fracture.
What laboratory tests should be done to rule out secondary causes of osteoporosis?
Check calcium, phosphorus, alkaline phosphatase, TSH, vitamin D, free PTH, creatinine, and CBC.
What lifestyle changes are recommended for osteoporosis treatment?
Recommended lifestyle changes include diet, exercise, stopping smoking, vitamin D supplementation, and reducing alcohol intake.
What are first-line treatments for osteoporosis?
First-line treatments include bisphosphonates like alendronate (70mg/day) and risedronate (35mg/day).
What is a selective estrogen receptor modulator (SERM) used for osteoporosis?
Raloxifene (60 mg/d PO) is a SERM used for osteoporosis.
What is denosumab?
Denosumab is a new antiresorptive agent, a monoclonal antibody, administered as an injection of 60mg every 6 months.
What is teriparatide?
Teriparatide is a treatment that induces bone formation, administered as a daily injection for a maximum of 2 years.
