Osteoporosis

Question 1

What is osteoporosis?

Answer 1

Disease characterized by micro deterioration of bone that leads to decreased bone mass, bone fragility, and increased risk of bone fractures.

Question 2

T/F: Bone scintigraphy is the gold standard imaging technique for diagnosing osteoporosis?

Answer 2

False - DEXA

Question 3

Primary Osteoporosis

Answer 3

• Caused by increase in age and decrease in sex hormone production/function

Question 4

Secondary Osteoporosis

Answer 4

• Caused be another illness or medication use that cause accelerated bone loss

Question 5

Risk Factors for Osteoporosis (9)

Answer 5

• Genetics
• Low calcium intake
• Low vitamin D
• Smoking/Drinking alcohol
• Prior history of fracture
• Medication
• Malabsorption problems
• Excessive urinary excretion of calcium
• Hyperthyroidism

Question 6

How can patients manage their osteoporosis? (4)

Answer 6

• Proper calcium intake
• Proper vitamin D levels
• WBing exercise
• Avoid smoking and excessive alcohol use

Question 7

What are bisphosphonates? (2)

Answer 7

• Medications that are given to improve osteoporosis.
• They focus on inhibiting osteoclast (bone reabsorption) activity

Question 8

What are the side effects of bisphosphonates? (6)

Answer 8

• Upper GI irritation
• Bone loss in the jaw
• Musculoskeletal pain
• Hypocalcemia
• Scleritis
• Atypical femur fractures

Question 9

What is a fragility fracture?

Answer 9

• Fracture that occurs non-traumatically (fracture occurs from falling from a standing height or less).
• Very big sign patient has osteoporosis

Question 10

What are some of the laboratory tests used to diagnose osteoporosis? (7)

Answer 10

• Comprehensive metabolic panel
• CBC (complete blood cell count)
• 24 hr urine for calcium/creatine/sodium
• Vitamin D levels
• TSH (thyroid stimulating hormone)
• PTH (parathyroid hormone)
• SPEP/UPEP if anemia is suspected

Question 11

What is a common physical assessment test for osteoporosis?

Answer 11

• Timed up and go test

Question 12

What is calcium carbonate and calcium citrate?

Answer 12

• Both calcium supplements

Question 13

What are the guidelines for using calcium carbonate? (2)

Answer 13

• Need stomach acid for absorption
• Take with meals

Question 14

What are the guidelines for using calcium citrate? (3)

Answer 14

• Can be taken w/ or w/out food
• Limit 500mg per dose
• May cause constipation

Question 15

What are some good exercises osteoporosis patients should be doing? (4)

Answer 15

• 30 mins of exercise most days of wk recommended
• WBing exercise (walking, running, elliptical)
• Muscle strengthening
• Balance

Question 16

Why are WBing exercises so important for osteoporosis?

Answer 16

• Increase bone mineral density

Question 17

Why do pre-menopausal women need to engage in resistance and high impact WBing exercise?

Answer 17

• Increase bone mineral density as much as possible before hormonal changes occur w/ menopause