Osteoporosis Flashcards

1
Q

How many individuals have osteoporosis above the age of 50

A

10 million

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2
Q

What is osteoporosis

A

Skeletal disease

Low bone mineral density

Changes in the microarchitecture of bone which increases chance of fracture

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3
Q

Osteoporosis is often found in

A

Postmenopausal women and in men above 50

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4
Q

osteoporosis is found when a bone mineral density T score of < -2.5 in the

A

Lumbar spine

Femoral neck

Forearm

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5
Q

What is Type 1 primary osteoporosis

A

Most common in women after menopause

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6
Q

What is type 2 primary osteoporosis

A

Decline in bone density and strength by aging (senile osteoporosis)

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7
Q

What is secondary osteoporosis

A

Caused by something else (medical condition)

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8
Q

A bone mineral density T score of -1 and -2.5 is considered to be

A

Osteopenia

Which is low bone density

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9
Q

A bone mineral density T score of less than -2.5 is considered to be

A

Osteoporosis

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10
Q

Risk factors of osteoporosis

A

So many…

Look on slide 19

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11
Q

What are the two types of bone

A

Cortical

Trabecular

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12
Q

What is cortical bone

A

Compact and solid

Dense deposits of mineral

Found in LONG bone

80% of bone mass

20% of bone surface area

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13
Q

What is trabecular bone

A

Spongy or cancellous

Bone marrow fills the space between

Found in the ends of long bones, vertebral bodies and calcaneus

20% of bone mass

80% of bone surface area

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14
Q

Cortical bone have _______ walls

Have more ________

Pores are developed in the _______

A

Thinner

Porous

Shaft walls

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15
Q

There are _______ Trabecular bones

They are generally ________

They have ________

A

Fewer

Thinner

Vacant space

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16
Q

What is the process of bone repair

A

Rest

Osteoclasts - bone resorption

Osteoblasts - bone formation

Rest - new bone

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17
Q

Bone resorption vs bone formation in:

Osteoporosis
Normal bone
Osteopetrosis

A

Bone resorption > Bone formation

Bone resorption = Bone formation

Bone resorption < Bone formation

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18
Q

What are the drugs used for treatment/prevention of osteoporosis

A

Antiresorptive medications

Anabolic drugs

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19
Q

What do antiresorptive drugs do

A

Action on Osteoclasts
Bone loss slowed
New bone is still made at same pace

exampels:
Bisphosphonates, calcitonin, denosumab, estrogen and estrogen agonists/antagonists

20
Q

Anabolic drugs do what

A

Action of osteoblast

Increase the rate of bone formation

Teriparatide

21
Q

What does physical activity do for osteoporotic fractures

A

Reduce risk for fractures

Enhances the peak bone mass achieved during growth and development

Slowing the rate of bone loss with aging

Reducing the risk of falls via benefits on muscle strength and balance

22
Q

Physical activity plays a prominent role in primary and secondary prevention of osteoporosis

A

True

23
Q

Physical activity is _______ associated with risk of hip and spine fracture

A

Inversely

24
Q

Exercise training can ______ or ______ the decrease in spine and hip bone mineral density

A

Increase

Slow

25
Q

What is necessary to test people with osteoporosis

A

Use a cycle leg ergometry

Especially for people with severe vertebral osteoporosis - walking is painful

26
Q

Vertebral compression fractures leading to a loss of height and spinal deformation can

Therefore this can affect

A

Compromise ventilatory capacity and result in a forward shift in center of gravity

Balance during treadmill walking and a handrail support would be required

27
Q

Max muscle strength testing may be ________ in patients with severe osteoporosis

However, there are ______ for _________ for maximal muscle strength testing

A

Contraindicated

No established guidelines

Contraindications

28
Q

What are the FITT recommendations for individuals at risk for osteoporosis

A

Frequency:
3 - 5 days/wk for aerobic
2-3 days/wk for resistance

Intensity:
Aerobic = moderate to vigorous
Resistance = moderate to vigorous

Time:
30 - 60 mins/day

Type:
Weight bearing aerobic
Jumping
Resistance exercise

29
Q

What are the FITT recommendations for individuals with osteoporosis

A

Frequency:
4 - 5 days/wk for aerobic
2-3 days/wk for resistance
5-7 days/wk flexibility

Intensity:
Aerobic = moderate
Resistance = adjust so that last 2 reps are challenging

Time:
Aerobic = Begin with 20 mins
Progress to min 30mins, max 45-60mins

Resistance = 1 set, 8-12 reps
Increase to 2 sets after 2 weeks
8-10 exercises

30
Q

What are the special considerations for people with osteoporosis

A

Difficult to quantify exercise intensity due to bone loading forces

Currently no established guidelines regarding contraindications for exercise

For older women and men at increased risk of falls they should include activities that improve balance

31
Q

General recommendation is to prescribe

A

Moderate intensity exercise that does not cause exacerbate pain

32
Q

Exercises that cause ______________ of the spine should also be avoided

A

Twisting, bending or compression

33
Q

Should the frailest elderly people remain physically active

A

True

34
Q

What are some lifestyle modifications that can be done

A

Calcium and vit D

Do weight bearing and resistance training

Avoid tobacco

Avoid alcohol

DXA scan and take medications if recommended

35
Q

What is the bottom line

A

Physical activity is vital in primary and secondary osteoporosis prevention

Weight bearing aerobic and resistance exercise is vital to help with risk for osteoporosis

It is difficult to quantify the magnitude of bone loading forces but generally increase in parallel with exercise intensity

36
Q

Physical activity improves body composition by increasing lean body mass and decreasing fat mass in older adults

A

True

37
Q

Any modality that impose excessive orthopedic stress is recommended to improve aerobic capacity for older adults who have join problems

A

False

38
Q

Type 1 osteoporosis occurs commonly in postmenopausal women

A

True

39
Q

The bone mineral density range for osteoporosis is T-score between -1 and -2.5

A

False

40
Q

Osteoporosis occurs when activity of osteoclasts is greater than the activity of osteoblasts

A

True

41
Q

Bisphosphonates are the type of anti-resorptive medications which increase the rate of bone formation

A

False

42
Q

Vertebral compression fractures leading to a loss of height and spinal deformation can compromise ventilatory capacity and result in a forward shift in the center of gravity

A

True

43
Q

Exercises that involve high impact loading should be suggested for people with osteoporosis because it helps increase bone mineral density

A

False

44
Q

Trabecular bones compose about 80% of bone mass

A

False

45
Q

Type 2 osteoporosis is also called as _____ osteoporosis because bone density and strength are declined by aging

A

Senile