B6.052 Prework 4: Intro to Osteoporosis

Question 1

osteopenia

Answer 1

decreased bone mineral density

T score = -1 to -2.5

Question 2

osteoporosis

Answer 2

osteopenia severe enough to significantly increase fracture risk
T score = less than -2.5

Question 3

signals of osteoporosis

Answer 3

atraumatic or vertebral compression fracture

Question 4

results of osteoporosis on bone

Answer 4

thinning of cortex
reduced trabecular bone mass
loss of trabecular connectivity
all contribute to elevated risk of fracture

Question 5

key mediators of osteoporosis

Answer 5

resorption > formation

• defects in signaling
• age related changes
• endocrine related changes

Question 6

when do you reach PBM

Answer 6

early adulthood after cessation of skeletal growth

Question 7

when does bone mass start to decline

Answer 7

begins in 40s, resorption > formation

steady decline in skeletal mass

Question 8

epidemiology of osteoporosis

Answer 8

ten million individuals > 50 yo have evidence of hip osteoporosis
1.5 x 10^6 osteoporotic fractures/year
lifetime risk, osteoporotic fracture after 50: 1/2 for women, 1/5 for men

Question 9

sex differences in bone loss with aging

Answer 9

1) short phase (3-5 y post menopause): rapid loss of mainly trabecular bone in women
2) longer phase (10-20 y): slower loss (age-related bone loss), both cortical and trabecular compartments, women and men

Question 10

reasons for sex differences in bone loss

Answer 10

bone architecture: boys have wider bones with thicker cortical regions
role of sex hormones in bone remodeling

Question 11

factors associated with increased risk of osteoporosis in post menopausal women

Answer 11

age
maternal history of fracture
face- Hispanic and Asian
current cortisone user
current/former smoker

Question 12

factors associated with decreased risk of osteoporosis in post menopausal women

Answer 12

elevated BMI
regular exercise
race- lower in AAs
alcohol use
current/former estrogen use

Question 13

why does elevated BMI present a decreased risk of osteoporosis

Answer 13

mechanical stress inhibits sclerostin release, allows for increased bone formation
excess adipose presents with and increase in estrogen because of increased aromatase

Question 14

primary osteoporosis

Answer 14

women with natural menopause and older men

Question 15

secondary osteoporosis

Answer 15

result of other disease, condition, or drug induced

Question 16

causes of secondary osteoporosis

Answer 16

endocrine disorders
autoimmune disease
digestive and GI disorders
hematologic/blood disorders
neuro/ nervous system disorders / mental illness
cancer
connective tissue disorders
drug induced disorders

Question 17

most common cause of secondary osteoporosis

Answer 17

glucocorticoid induced bone loss

• pharmacologic doses of steroid used for inflammatory or autoimmune disorders
• longer duration + higher doses of steroids is most likely to cause bone loss and fractures
• individuals with cushingoid appearance