Osteoporosis Flashcards Preview

PTRS 746 Exam 1 > Osteoporosis > Flashcards

Flashcards in Osteoporosis Deck (45):
1

Content: 3 ways to define osteoporosis.

1. Microarchitectural deterioration of bone tissue leading to decreased bone mass

2. Bone fragility

3. Susceptibility to fracture

2

Q: Osteoporosis is a problem of _________ peak bone _____ and _____________ bone _____.

decreased, mass, increased, loss

3

Q: How many million individuals in the US are affected by osteoporosis?

10 million

4

Q: When does bone mass peak?

Between 20-25 yo

5

Q: When does bone mass begin to decline?

Around 50 yo

6

Q: What imaging is often used to identify osteoporosis?

DEXA

7

Q: What is BMD?

Body mass density - comes from a DEXA test

8

Defn: T-score

number of standard deviations from the young adult mean density

9

Defn: Z-score

number of standard deviations from age matched mean density

10

Q: What T-score indicates osteoporosis?

< -2.5

11

Q: What T-score indicated osteopenia?

-1 to -2.5

12

T/F: For every standard deviation below the norm, the risk of fractures triples.

False: doubles

13

Q: When does the z-score apply for osteoporosis?

pre-menopausal females and males < 50

14

Q: What is FRAX?

Fracture Risk Assessment Tool

15

Q: What does FRAX calculate?

10 year fracture risk, for things like hip fracture and osteoporosis fractures

16

T/F: FRAX is the treatment decision making tool in previously treated pts.

False, untreated

17

Content: Primary Osteoporosis (2)

1. unrelated to chronic illness

2. Related to aging and decreased gonadal function

18

Content: Secondary osteoporosis (2)

1. Secondary to chronic illnesses/meds that cause accelerated bone loss

2. Ex. glucocorticoid use, hyperthyroidism

19

Content: Risk factors for Osteoporosis (10 - general idea)

1. Genetics

2. Low Ca intake

3. Low vitamin D stores

4. Tobacco and alcohol us

5. Prior history of fracture

6. Medications

7. Malabsorpation

8. Excessive urinary calcium

9. Overactive thyroid gland

10. Other medical conditions

20

Content: Secondary Evaluation of Osteoporosis (7)

1. Comprehensive metabolic panel

2. CBC

3. 24 hour urine for Ca, creatinine, Na

4. 25-Hydroxy Vit D

5. TSH

6. SPEP/UPEP if anemic

7. PTH

21

Q: How do you assess fall risk?

TUG - Timed get up and go

22

Content: TUG (5)

1. Stand from a seated position

2. Walk ~10 ft

3. Turn around

4. Return to seated position in chair

5. Normal time < 10 seconds

23

Content: Life choices and bone health (5)

1. Adequate Ca intake (~1200 mg/day)

2. Optimal Vit D levels

3. WB exercise

4. Avoid tobacco use

5. Avoid excessive alcohol use

24

Q: How much Ca is in 8 oz of milk?

300 mg

25

Q: What calcium supplements are available?

1. Calcium carbonate

2. Calcium citrate

26

Content: Calcium carbonate (2)

1. Needs stomach acid for absorption

2. Taken with meals

27

Content: Calcium citrate

Can be taken with or without food

28

Content: Calcium supplements (2)

1. Limit to ~500 mg in a dose

2. May cause constipation

29

Content: Vitamin D supplementation (5)

1. Vit D2 - ergocalciferol

2. Vit D3 - cholecalciferol

3. supplementation guided by 250HD value

4. Can be taken with or without food

5. Safe upper limite = 2,000IU

30

Diagram: Vit D formation

A image thumb
31

Q: What is the recommendation for exercise to prevent osteoporosis?

30 min, most days  of running, walking, or elliptical + muscle stregnthening and balance exercises

32

T/F: WB activities decrease BMD.

False

33

T/F: High impact WB exercise increased BMD by 1-2% at the spine and hip.

True

34

Q: What type of training increased spine BMD?

Resistance

35

Q: What type of training increased hip BMD?

high impact

36

T/F: Menstraul cycle effects gains in BMD.

True

37

Q: Who will be referred to PT for osteoporosis type treatment?

Those at increased risk or fall, unstable gait, weakness

38

Q: What are pharmacologica treatment options for low bone mass? (4)

1. Bisphosphonate

2. Teriparatide

3. Denosumab

4. Selective Estrogen Receptor Modulators

39

Content: Types of Bisphosphonates (4)

1. Alendronate -wkly

2. Risedronate - wkly/moly

3. Ibandronate - moly/IV every 3 mo

4. Zolendronic Acid - IV annually

40

Diagram: Mechanism of Action of Bisphosphonates - Osteoclasts are targets

A image thumb
41

Content: Side Effects of Bisphosphonates (6)

1. Upper GI irritation

2. Osteonecrosis of the jaw

3. Severe musculoskeletal pain

4. HypoCa

5. Scleritis

6. Atypical femur fractures

42

Content: Teriparatide (2)

1. Anabolic (bone building agent)

2. Daily injection

43

Content: Denosumab  (3)

1. Inhibits osteoclast function

2. Decreases bone resorption

3. Consider in pts. with kidney dysfunction

 

44

Q: What medications put you at high risk for osteoporosis? (3)

1. Steroids

2. Aromatase inhibitors

3. Androgen deprivation therapy

45

Q: For bone health how often should bone density be evaluated?

On treatment = every 1-2 years

Not on treatment = every 2 years