Metabolic Bone Disease

Question 1

What is Osteoporosis?

Answer 1

Bone Deterioration w/ Reduced bone mass.
Disruption of micro architecture of bone
Inc risk of fracture

Question 2

What is Osteoporosis?

Answer 2

Bone Deterioration w/ Reduced bone mass.
Disruption of micro architecture of bone
Inc risk of fracture

Question 3

What does the T-Score of Bone density tell you?

Answer 3

Comparison to young Adults

Question 4

What does the Z-Score of Bone density tell you?

Answer 4

Comparison to Age matched adults

Question 5

What T score is equated to osteoporosis?

Answer 5

T score

Question 6

What T score is equated to Low bone density (osteopenia)?

Answer 6

-1.0 to -2.5

Question 7

What is a normal T score?

Answer 7

-1.0 to +1.0

Question 8

Who should T-Score NOT be used for?

Answer 8

Children
Pre-Menopausal Women
Men

Question 9

When is a Z score used?

Answer 9

Pt younger than peak bone mass
Pre-Menopausal Women
BD Lower than expected
Men

Question 10

What are clinical Risk factors for fragility fracture?

Answer 10

Advancing age
Prev Fracture
GLC Thx
Parental Hx of Hip Fracture
Low Body Wt
Smoking, EtOH, RA, 2^ OP

Question 11

What are clinical Risk factors for fragility fracture?

Answer 11

Advancing age
Prev Fracture
GLC Thx
Parental Hx of Hip Fracture
Low Body Wt
Smoking, EtOH, RA, 2^ OP

Question 12

What is the Reccomended Daily Ca intake?

Answer 12

800 to 1000 IU/d of Vit D3

Question 13

What does the Z-Score of Bone density tell you?

Answer 13

Comparison to Age matched adults

Question 14

What T score is equated to osteoporosis?

Answer 14

T score

Question 15

What T score is equated to Low bone density (osteopenia)?

Answer 15

-1.0 to -2.5

Question 16

What is the MOA of DENOSUMAB?

Answer 16

Binds RANK ligand and Inh Osteoclast Med-Bone Destruction

Question 17

Who should T-Score NOT be used for?

Answer 17

Children
Pre-Menopausal Women
Men

Question 18

When is a Z score used?

Answer 18

Pt younger than peak bone mass
Pre-Menopausal Women
BD Lower than expected
Men

Question 19

What Z-Score equates to 2^ osteoporosis?

Answer 19

less than -2.0

Question 20

What are clinical Risk factors for fragility fracture?

Answer 20

Advancing age
Prev Fracture
GLC Thx
Parental Hx of Hip Fracture
Low Body Wt
Smoking, EtOH, RA, 2^ OP

Question 21

What kind of rickets is caused by Dietary Def of Vit D and/or Ca?

Answer 21

Calcipenic Rickets

Question 22

What is the Reccomended Daily Ca intake?

Answer 22

800 to 1000 IU/d of Vit D3

Question 23

What testing is recommended for women >65 and Men >70?

Answer 23

BMD testing

Question 24

What are the limitations of FRAX?

Answer 24

only applied to Pts naive to Tx

Only T-Score from the hip. not peripheral or Spine T-Score

Question 25

What is the Tx of Osteoporosis?

Answer 25

Anticat Bisphosphonates/ SERM/Denosumab) vs Anabolic Thx

Question 26

What is the MOA of DENOSUMAB?

Answer 26

Binds RANK ligand and Inh Osteoclast Med-Bone Destruction

Question 27

What are the traits of Paget's Disease of the bone?

Answer 27

Abn of the osteoclast. accel bone turnover and abn bone remodeling. AD w/ var penitrance

Question 28

What are clinical signs of PDB?

Answer 28

Radic due to Nerve Compression, Back pain, Hearing loss, headache, Joint rep surgery, High OP HF. Hyper Calcuria

Question 29

What are lab findings in PDB?

Answer 29

Inc bone turnover => Inc Alk phos, Bone TO markers increased => Ca and Phos normal

Question 30

What is the Treatment of PDB?

Answer 30

Monitor Alk phos | Bisphosphonates - Zoledronic Acid

Question 31

What kind of rickets is caused by Dietary Def of Vit D and/or Ca?

Answer 31

Calcipenic Rickets

Question 32

What kind of rickets is caused by Renal Phosphate Wasting?

Answer 32

Phosphopenic Rickets

Question 33

What are the lab findings in Osteomalacia?

Answer 33

``` Alk phos Elevated Serum Ca and Phos reduced Urine Ca low in 87% Low 25 OH VD PTH elevated ```