Osteoporosis Flashcards Preview

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Flashcards in Osteoporosis Deck (27):
1

what are the 2 main features of bone strength

1. bone density
2. bone quality

2

4 factors involved in peak bone quantity4

1. genetics (60%)
2. bone modelling
3. mech factors
4. nutrition (Ph and Ca)

3

4 things age related bone loss

1. bone remodelling
2. genetics(vit D receptor)
3. diet/lifestyle
4. disease and drugs

4

what is esp. important in women

estorogen

5

5 diseases

1. hyperparathyroidism
2. hyperthyroidism
3. hypogoinadism (anorexia, ovarian failure or early menopause)
4. malabsorbtion/malnutirion
5. rheumatoid arthritis

6

5 important drugs

1. glucocorticoids
2. anti-Est
3. anti-andro
4. SSRIs
5. PPIs

7

4 things bone quality depends on

1. architecture (size and shape)
2. bone turnover (remodeling rate)
3. accumulated damge - microfractures
4. quality of mineralization

8

2 main types of fractures over 65

vert, hip wrist

9

def. fragility fracture

1. from minimal trauma (standing hieght)
2. wrist, vert, hip, humerous, pelvis
NOT skull, metas, or ankle

10

Hx risk factors (5)

1. age >65
2. gender
3. lifestyle - tobac, alc, caf
4. disease and drugs
5. fam Hx - esp first female

11

Important physical exams

1. vision
2. gait
3. quad strenght
4. balance
5. height loss
6. kyphosis
7. percussion tenderness
8. illiac to rib

12

4 poss. lab studies

1. CBC wth MCV
2. creat/liver
3. Ca, Ph, albumin
4. vit D

13

2 other tests

1. spine x-rays
2. DXA (dual xray absobometry)

14

what does DXA tell us (2)

1. T score for pop
2. z score for ref. group

15

what defines osteo with DXA

under 50 -

16

* what is 10 year fracture risk made up of (3)

1. gender
2. age
3. bone density

17

2 modifiers to 10 year and how to deal with

1. prednisone
2. previous fracture
(move up a category)

18

what is intervention based on risk cat

low risk - CA, vit D, lifestyle
med risk - not sure
high risk - pharma, diet life style

19

5 lifestyle things to avoid

1. weight restriction (BMI

20

Ca and Vit D reccomendation

Ca - 1200 mg/day
Vit D - 800-1000IU

21

2 pharma treatments

1. antiresorbative - target clasts
2. anabolic - target blasts

22

SEs of pharma

early - esophageal irritation, bone pain
late - osteonecrosis of jaw, femoral fractures

23

4 contraindications

1. hypocalcemia**
2. low vit D **
3. active upper GI disease
4. renal dysfucntion

24

what is RANKL inihib

denosumab
- stops clast activation

25

what are SERMS

raloxifene
- bone agonist
- breat and uterus antag

26

2 pops not to use raloxofen

1. pre-meno
2. men

27

what is effect of meds

50% drop in VCF
0-50% drop in non-vert fractures

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