Osteoporosis Flashcards by Sydney Perry

Bones consist of _____, _____, and _______

collagen fibers
hydroxyapatite
bone proteins

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hydroxyapatite is __________ in combination with ______

salts of calcium and phosphate
hydroxyl ions

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bone proteins (2) ?

osteocalcin
osteopontin

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compact bones in the shaft of long bones

conical bone

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spongey bone found in the knobby ends of long bones, iliac crest, vertebrae, wrists, scapulas, and regions of bone that line the marrow

trabecular bone

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trabecular bone provides _____ that is exposed to ______ from the ______

increased loss of this bone with _______, it is more responsive to ______

surface area
circulating fluids
marrow

aging
estrogen

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cell responsible for formation of bone tissue

does this through synthesis of ____ and _____

osteoblast

collagen
bone proteins

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cell associated with the resorption and removal of bone

this occurs through release of ______ and _____

osteoclasts

acids
proteolytic enzymes

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Where is calcium found?
what occurs when calcium intake in inadequate

99% of calcium is found in skeleton
1% in extracellular fluid

serum Ca decreases=> parathyroid hormone (PTH) levels increase=> stimulates osteoclast activity to=> pull Ca from the bone to maintain normal serum levels

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increases intestinal Ca absorption

Calcitriol (active vitamin D)

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The skeleton grows until mature ______ is achieved
At this time, bone formation____ bone resorption
Completed in females by ~ ______ and males ~ ______

height
>
age 18
age 20

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Process where bone is continuously resorbed and reformed through the action of osteoclasts & osteoblasts

bone remodeling

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bone remodeling is initiated by ________

cytokines, interleukin-1

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respiration means _____

bone loss

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Young, healthy adults=> resorption & formation are ________

Older adults=>_________ with increased resorption=> _____

balanced, and bone mass is maintained

bone loss

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A measurement of the mineral content of bone per unit of bone
Measured by _____________

Bone mineral density (BMD)
Bone Densitometry (DEXA)

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Maximum amount & density of bone accumulated ?
Bone _____ continues to accumulate after the length stops.
Peak bone mass is reached by ~age ____
Greater in_______

peak bone mass
mass
30
men

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secondary osteoporosis is caused by what diseases and conditions?

Hyperparathyroidism
Chronic kidney disease
Chronic malabsorption
Chronic immobilization

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secondary osteoporosis is caused by what medications?

Corticosteroids
Phenytoin (Dilantin)
Heparin
Methotrexate
Proton pump inhibitors (e.g., Prilosec)

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Risk factors for Osteoporosis include…

Age, especially > ____years
______ gender
Hypothalamic amenorrhea
_________ of osteoporosis
_______ depletion from Menopause or Early oophorectomy
Ethnicity: __________
________ depletion

60
Female
Family history
Estrogen
Asian or Caucasian
Androgen

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Risk Factors for Osteoporosis

________ that adversely affect bone or calcium metabolism
_______ smoking
Lack of _______
______ weight
_______
Inadequate __________ intake
Excessive ______ intake

Medications
Cigarette
exercise
Under
Sarcopenia
calcium or vitamin D
alcohol

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Lifestyle Modification
- Adequate intake of ________ and ________ to meet the DRIs
- Decrease ______ intake to moderate level
- _______ cessation

Increase exercise:
______________=>intensive walking, jogging, cycling, walking stairs
___________ (e.g., lifting weights, resistance bands, squats, planks, push-ups)
_____________

Ca & Vitamin
alcohol
Smoking

Weight-bearing aerobic activity
Resistance training
Balance exercises

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calcium recommendation for
9-18
19-50
51-70
>70

1300 mg
1000 mg
1000 mg for males & 1200 mg for females
1200 mg

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calcium consumption ????????????

???????? idk what she said ab this

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Sources high in Calcium

dairy products fortified foods (OJ, soy milk, cereals) Tofu Sardines

sources that are sources of calcium but are a lil less

salmon turnip and collard greens soybeans almonds legumes kale broccoli

foods with _____ mg or more of calcium is a good source. However, we can only absorb _____ mg at one time.

200 mg 500 mg

Factors that enhance Ca Absorption

Vitamin D Lactose * spread calcium throughout the day to maximize absorption

Factors that decrease Ca Absorption

oxalates Potatoes excessive insoluble fiber zinc supplements

examples of oxalates

spinach rhubarb nuts chocolate celery beets

examples of phtates

legumes nuts seeds whole grains

Mean intake for females > 12 yrs _______ meet the DRI Average intake for: Age 12-19 yrs: _____ mg/d females; _____ mg/d males Age > 20 yrs: ____ mg/d females; ____ mg/d males Age > 70 yrs: ______ mg/d females; _______ mg/d males

does not 822 1105 842 1056 771 933

Indications that may require calcium supplements

osteopenia or osteoporosis inadequate intake lactose intolerance malabsorption medications that decrease Ca absorption (e.g., corticosteroids)

absorption of calcium is optimal when taken ____________ which may include _______. should choose a supplement that has the _______ sign

individual doses off ≤500 mg vitamin D United States Pharmacopeia (USP)

__________=> contains the most Ca per tablet; ____% elemental calcium __________=> ____% elemental calcium; most efficient absorption

Calcium Carbonate 40% Calcium Citrate 20%

calcium carbonate example

Caltrate Oscal Viactiv

calcium citrate example

Citracal

Tolerable Upper Intake Level (UL): Calcium __________ mg (age 19-50 yo) ________ mg (>51 yo)

2500 2000

excessive calcium intake can result in ________ Deficiency of____ & other minerals Hypercalcemia can cause: __________ of soft tissues and blood vessels _________ and ________ symptoms

Kidney stones iron calcification constipation & nausea

______________ enhances Ca absorption

1,25 dihydroxvitamin D

Risk of vitamin D deficiency due to=> inadequate exposure to _____, inadequate ______ vitamin D, or impaired _________ of vitamin D (___________)

sun dietary activation (kidney disease)

Sources of vitamin D:

Ultraviolet rays from the sun Egg yolks Fortified milk Cheese, yogurt Fatty fish: salmon, tuna, mackerel, sardines, & catfish Some mushrooms Fortified soy milk, fortified OJ

Older adults often require supplementation mean reccommendations of vitamin D

15 ug

Avoid excessive vitamin D supplementation - can cause _______________

hypercalcemia

1 mcg = _____ IU

Vitamin K required for the maturation process of __________ which is involved in the __________ process

osteocalcin bone mineralization

Individuals at risk for deficiency of vitamin K - ____________ may have inadequate consumption of vitamin K - ___________ therapy - __________

Elderly individuals Antibiotic Malabsorption

Dietary Sources of Vitamin K

Green leafy vegetables: spinach, broccoli, collard, mustard, & turnip greens, kale Green tea Canola & soybean oil

High intake of dietary sodium increases urinary ____ excretion Avoid foods with > _____ mg Na per serving

Ca 300

Adequate protein intake is needed for optimal bone health Recommend _______ for protein Higher intakes may be beneficial for _________ However, excessive consumption may increase urinary ____ excretion

the RDA older adults Ca

Alcohol is toxic to _______ at high doses Intake of >___ drinks/d for an extended period is associated with lower _______ and increase risk of ________ Moderate intake is believed to have ________ effect on bone

osteoblasts 3 bone density osteoporosis no detrimental

Relationship with osteoporosis and caffeine ? Ingestion of caffeine causes short-term increase in_________ Drinking > _____ cups of coffee/day may interfere with _______________

has not been clearly established urinary calcium excretion 3 calcium absorption and cause bone loss

Drugs for preventing and treating osteoporosis are usually recommended to be taken along with: _______________ _______________ Ideally both would be achieved from dietary sources, but if not, supplements should be used

Calcium (1000-1200 mg/day) Vitamin D (800-1000 IU/d)

Inhibit osteoclast-mediated bone resorption FDA-approved for prevention & treatment of osteoporosis in ___________ women ___________ are also approved for use in male osteoporosis

bisphosphates post-menopausal women Alendronate & risedronate

bisphosphate examples

Alendronate (Fosamax) Risedronate (Actonel) Ibandronate (Boniva)

Side effects of Bisphosphates

GERD esophagitis

estrogen Agonist Stimulate estrogen receptors in bone tissue which ____________

decreases bone reabsorption

Estrogen Agonists are FDA approved for both prevention & treatment of osteoporosis in_________women Little effect on ______ or ______ tissue

postmenopausal breast or uterine

Estrogen Agonists Example

Raloxifene (Evista)

____________ is Low doses of a synthetic, modified parathyroid hormone

Teriparatide (Forteo)

Teriparatide (Forteo) Increases _______________=> which is a _______ process FDA-approved for treatment of osteoporosis in _______ women & males at high risk for ___________

osteoblastic formation of new bone tissue anabolic post-menopausal fracture

Medications for Osteoporosis

Estrogen Agonists - Raloxifene (Evista) Bisphosphates - Alendronate (Fosamax) - Risedronate (Actonel) - Ibandronate (Boniva) Teriparatide (Forteo)

Osteoporosis Flashcards

(62 cards)