Lecture 28-Bone Health, Falls and Fractures

Question 1

by what age is the skeleton completely hardened

Answer 1

25

Question 2

how many bones are in the human body

Answer 2

206

Question 3

Osteoclasts and osteoblasts

Answer 3

Osteoclasts tear down and osteoblasts build bone throughout the lifespan with the processes of resorption and deposition

Question 4

bone resorption is the action of what

Answer 4

osteoclasts and parathyroid hormone

Question 5

bone deposition is the action of what

Answer 5

osteoblasts and calcitonin

Question 6

bone resorption and bone deposition is regulated by

Answer 6

thyroid and parathyroid glands

Question 7

an osteoblast ….

Answer 7

forms new bone tissue

Question 8

an osteoclast …..

Answer 8

breaks down old bone tissue

Question 9

what plays vital roles in bone development, growth and repair

Answer 9

vitamin A, vitamin D, calcium and other hormones

Question 10

rates of bone growth is highest when

Answer 10

infancy and pubertal growth spurt

Question 11

velocity of bone growth doubles when

Answer 11

adolescence critical period

Question 12

~40% of peak bone mass is laid down when

Answer 12

end of puberty

Question 13

at age 20 what % of peak bone mass is attained

Answer 13

90-95%

Question 14

what happens to bone mass after your mid 30s (also how does men and women bone mass change throughout their life)

Answer 14

you begin to slowly lose bone mass

women lose bone mass faster after menopause, but it happens to men too

Question 15

what are the determinants of bone strength

Answer 15

• bone mineral density
• geometry

Question 16

what is the most important effect of stress on the bone and what is this

Answer 16

strain

measurement of deformation of bone to external load

Question 17

what is said about your ground reaction forces if you are lighter

Answer 17

the lighter you are the smaller your ground reaction forces are

Question 18

peripheral skeleton bone strength is positively associated with what

Answer 18

total and dairy protein intake in healthy postmenopausal women

Question 19

In elderly there is

Answer 19

• inadequate intake of protein
• reduced ability to use available protein
• greater need for protein

Question 20

In elderly
- inadequate intake of protein
- reduced ability to use available protein
- greater need for protein

leads to what

Answer 20

loss of functionality

muscle
bone
immune system

Question 21

what is the strategy to maximise and protect bone mass in children

Answer 21

achieve peak bone mass

Question 22

what is the strategy to maximise and protect bone mass in adults

Answer 22

maintain bone mass

Question 23

what is the strategy to maximise and protect bone mass in older adults

Answer 23

slowing bone loss

reducing falls and fractures

Question 24

osteoporosis NZ estimates how many older kiwis have broken a bone since their 50th birthday

Answer 24

> 180,000

Question 25

annually how many people sustain a hip fracture, and how many are admitted to hospital with other fractures

Answer 25

~3,700 hip fractures ~13,800 admitted to hospital with other fractures

Question 26

what are the three types of osteoporosis

Answer 26

age associated / post menopausal idiopathic secondary

Question 27

what are the risk factors of osteoporosis

Answer 27

-age -genetics -sex -physical activity -Diet -Hormones

Question 28

what are some diseases / genetics that are considered secondary risk factors for osteoporosis

Answer 28

-multiple myeloma -metastatic bone cancer -rheumatoid arthritis -pagets disease

Question 29

what % of hip fractures are due to falls

Answer 29

> 95%

Question 30

what is the 5th leading cause of death in older adults

Answer 30

falls

Question 31

what are some risks for falls in older adults

Answer 31

-muscle weakness -poor balance / physical activity -poor eyesight -benzodiazepine use

Question 32

what are the risks for fractures in falls for older people

Answer 32

- failure to break a fall - falling to the side - age : increased risk of osteoporosis - low bone mass

Question 33

a prior fracture at any skeletal sight does what

Answer 33

doubles future fracture risk

Question 34

what does sarcopenia and osteoporosis lead to increased likeliness of

Answer 34

fracture

Question 35

2nd fracture often

Answer 35

happens within 6-8 months

Question 36

does NZ have strength and balance programs to prevent falls in elderly

Answer 36

yes

Question 37

Vitamin D has an important role together

Answer 37

with calcium in mineral metabolism and bone growth and maintenance

Question 38

trials show what about vitamin D supplements and bone density

Answer 38

vitamin D supplements found to increase bone density

Question 39

what is found from clinical trials about vitamin D supplements and non skeletal endpoints

Answer 39

not demonstrated benefits on muscle mass or function

Question 40

calcium supplements in healthy individuals are ……

Answer 40

not needed nor required in most people receiving treatment for osteoporosis

Question 41

vitamin D supplementation is / isnt found to reduce risk of fractures

Answer 41

isnt

Question 42

the findings of vitamin D supplementation not being effective may not apply to ….

Answer 42

individuals with very low 25(OH)D levels, gastrointestinal disorders causing malabsorption or those with osteoporosis

Question 43

sarcopenia increases risk of ….. and osteoporosis increases risk of ….

Answer 43

sarcopenia increases risk of falls and osteoporosis increases risk of fractures they both link together

Question 44

sarcopenia and osteoporosis share

Answer 44

an underlying pathology

Question 45

Prevelance of osteoporosis was higher in

Answer 45

sarcopenia than in non-sarcopenic individuals

Question 46

co-occurrence (osteosarcopenia) is common and associated with a

Answer 46

higher degree of malnutrition than osteoporosis or sarcopenia alone