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Endocrine > Osteoperosis > Flashcards

Osteoperosis Flashcards

1
Q

Two major changes of osteoporosis

A

Lower bone density and lower bone quality (micro architectural disruption)

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2
Q

What is the proportion of women who have an osteoporotic fracture?

A

1 out of 2

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3
Q

Symptoms of uncomplicated osteoporosis

A

None its silent

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4
Q

Most serious osteoporotic fracture

A

hip

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5
Q

Most common osteoporotic fracture

A

vertebral

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6
Q

Men or women have worse mortality after hip fracture

A

men

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7
Q

Two main causes of pathophysiology of osteoporosis

A

Low peak bone mass (started off at lower baseline) (modeling)
Bone loss later in life (remodeling)

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8
Q

What is the cause of primary osteoporosis

A

Aging, seen in postmenopausal women and aging men

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9
Q

Causes of secondary osteoporosis- genetic

A

Parental hip fracture or idiopathic hypercalciuria

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10
Q

Causes of secondary osteoporosis- lifestyle

A

Low Ca intake, Vit D issues, Alcohol >3 drinks/day, low BMI

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11
Q

Causes of secondary osteoporosis- endocrine

A

hypogonadism, hyperthyroidism, premature ovarian failure, hyperparathyroidism

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12
Q

Causes of secondary osteoporosis- GI

A

inflammatory bowel disease, celiac’s

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13
Q

Causes of secondary osteoporosis- Meds

A

Lots of glucocorticoids- more than 5mg/day for more than 3 months, PPIs, Anticonvulsants, aromatase inhibitors

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14
Q

Causes of secondary osteoporosis- Rheum

A

RA, end stage renal disease

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15
Q

Diagnostic tool for osteoporosis

A

DXA scan

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16
Q

Where do you want to DXA scan for osteoporosis

what about for primary hyperparathyroidism/fatties

A

Hip, Femoral neck, Lumbar Spine

forearm

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17
Q

Diagnostic score for old/young population and what’s are they compared to

A

T-score for old- compared to young people to see how many SDs you are away from your peak bone mass
Z- score for young- age/race/gender matched

18
Q

DXA is only used for these two pops

A

postmenopausal women and men above 50

19
Q

T score ranges
Normal
Low bone mass
Osteoporosis

A

Normal- -1 or less SDs below mean
Low Bone Mass- between 1-2.5 below mean
Osteo- 2.5 SDs or lower below mean

20
Q

Patients who have had a history of ___ ___ are considered osteoporotic

A

History of fragility fractures

21
Q

Screen all women over _ and men over _

A

65; 70

22
Q

Screening ages for people with clinical risk factors for osteoporosis
Men
Women

A

Men- 50-69

Women- Postmenopausal women

23
Q

Relationship between fracture risk and SD of T score below mean

A

every 1 SD of T-score below mean double the risk of fracture

24
Q

Who do we treat according to
T score
History
FRAX test

A

T score more than 2.5 below mean
History of previous hip/spine fracture
FRAX score of 20% for any fracture or 3% for a hip fracture

25
Q

Age criteria for treatment- men and women

A

Men above 50, postmenopausal women

26
Q

Mnemonic for non-pharm treatment for osteoporosis

A 
Calcium
D vitamin
Exercise
Fall prevention
Good nutrition
Smoking
27
Q

What’s the only drug that increases bone formation by osteoblasts

A

teriparatide

28
Q

Preosteoblasts release __ which does what to osteoclasts

A

RANKL and it stimulates osteoclasts

29
Q

Mature osteoblasts release __ which does what to RANKL

A

OPG blocks RANKL so increases bone formation

30
Q

First line osteoporosis therapy

A

Bisphosphonates

31
Q

Bisphosphonate mech of action

A

It blocks osteoclasts and kills them

32
Q

Bisphosphonate short term common side effects (and the system it affects) and serious long term side effect

A

short term- flu like illness, GI issues

long term- Atypical fracture of femur and osteonecrosis of the jaw

33
Q

Denosumab inhibits what, and is good for what patient pop because of its metabolism

A

Inhibits Rank ligand, isn’t excreted by the kidney so renal failure patient

34
Q

Side effects of Denosumab

A

Hypocalcemia, skin issues, infection

35
Q

Teriparatide pretty much acts as ___ hormone

A

parathyroid

36
Q

Teriparatide has a window of bone anabolism before bone resorption occurs- must be given with what other drug

A

anti-resorptive agent

37
Q

Teriparatide major side effect

A

osteosarcoma

38
Q

Teriparatide contraindications

A

Paget’s disease, high alk phos,
hypercalcemia, h/o of skeletal malignancy,
radiation or mets

39
Q

Raloxifene is what type of drug

A

selective estrogen receptor modulator

40
Q

Raloxifene major contraindication

A

thromboembolism

Endocrine (25 decks)

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