Bone Disorders Flashcards
(18 cards)
osteoporosis definition
most common metabolic bone disease
bone mineral density T score < -2.5
osteoporosis risk factors
age > 50 thin weight < 154 low dietary calcium vit D deficiency tobacco or etoh use corticosteroids or anticonvulsants
contributors to osteoporosis
bone remodeling
bone reabsorption - releases Ca+ into circulation by osteoclasts
bone formation - osteoblasts lay down osteiod
steroid use - causes osteoblast death and prolongs life of osteoclasts
decreased estrogen and testosterone levels lead to increased metabolism of Vit D
more contributors
chronic opioid use chemotherapeutic agents anticoagulants anticonvulsants excessive thyroid hormone immunosuppresants
osteoporosis screening
women > 65
younger with increased risk factors
osteoporosis labs
vit D 25 serum calcium intact PTH TSH 24 hour urine calcium biochemical markers of bone turn over
osteoporosis verus osteopenia
bone mineral density T score between -1 and -2.5 = osteopenia
equal to or less than -2.5 is osteoporosis
osteoporosis prevention: calcium recommendations
men 50 - 70 years 1000 mg of calcium a day
women > 50 - 1200 mg of calcium a day
osteoporosis prevention: vit D
all adults > 50
Vitamin D : 800-1000 iu daily
osteoporosis prevention
regular weight bearing exercises walking joggin tai chi stair climbing dance tennis regular muscle strengthening exercises yoga pilates
osteoporosis tx:
bisphosphonates
prevent and tx postmenopausal OP:
- Fosamax
- Boniva
- Actonel
- Reclast
glucocorticoid induced OP (men and women)
- Fosamax
- Actonel
- Reclast
calcitonin
nasal spray
NOT indicated for PREVENTION
small increase in bone mass
tx continued
RANK ligand
PTH
selective Estrogen Receptor Modulator
= prevent and tx postmenopausal OP
=vertebral fracture reduction only
=increased risk of venous thrombosis and fatal stroke
HRT
only for PREVENTION of postmenopausal OP
Paget’s Disease
2nd most common metabolic bone disease in older adults
by age 80, 1 in 10 is affected by the disease
localized increase in bone turnover and blood flow increase number, size, and activity of osteoclasts - causing break down of bone. osteoblasts keep up with tunover - leading to new disorganized bone
monstotic or polyostotic
paget’s pain
bone pain
deep ache
worse with heat
pelvis, femur, tibia, spine, and skull are most commons sites
paget’s diagnosis on exam
increased head size
tenderness and warmth at affected site
deformities
paget’s diagnostics
serum alkaline phosphatase
urinary NTX level
x-ray
paget’s tx
bisphosphonates
calcitonin
NSAIDs
