Osteoporosis Flashcards

1
Q

3 types of osteoporosis

A
  1. primary
  2. secondary
  3. transient osteporosis of the hip
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2
Q

What is primary osteoporosis?

A

deterioration of bone mass, unassociated with other chronic illnesses or diseases

-Usually related to aging, menopause

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3
Q

What is secondary osteoporosis?

A

caused by various endocrine or metabolic disorders (G&S, Table 11-13, p. 439)

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4
Q

What is transient osteoporosis of the hip?

A

rare, idiopathic, transitory

  • middle-aged men and pregnant women
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5
Q

Pharmacology for Treatment of

Osteopenia/Osteoporosis (4)

A
  • Calcium supplements, ~ 1000 units/day
  • Vitamin D ~ 2000 units/day
  • Biophosphonates-(work by osteoblast activity, interferes/changes bonebuilding)- osteoporosis, Paget’s disease, others
    • Fosamax, Aredia, etc.
  • Estrogen therapy for post menopausal women and ovariectomy (also called oophorectomy) to preserve bone density
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6
Q

Methods for screening for osteoporosis

A
  • FRAX (Fracture Risk Assessment, WHO)
  • DEXA scan (Dual Energy X-ray Absorptiometry)
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7
Q

At what age do we start screening women for osteporosis?

A

60

•50% of women will fall below normal bone mineral density T-score and be candidates for medical treatment

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8
Q

Points about osteoporosis, age, and changes in bone

A
  • Age related bone remodeling and body type
    • Breakdown is greater than build-up
    • Bone growth and storage into the 20’s - diet and exercise puts bone in the bank!
  • Systemic and bilateral
    • Fracture and deformity risk systemically
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9
Q

Vertebral fractures and osteoporosis (pic)

A
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10
Q

What is Osteomalacia?

A
  • Softening of bones due to vitamin D deficiency, lack of exposure to UV rays
  • (note: ability to synthesis vitamin D through sunlight diminishes after age 40)
  • Looser’s transformation zones – pseudofractures in areas of demineralization
  • Called “rickets” in children, usually malnutrition – causes bowing of long bones due to malformation with epiphyseal plates
  • May have bowed legs
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11
Q

What is Paget’s disease? (3)

A
  • Genetic factors or viral infection that produces disordered bone modeling (not systemic)
  • Produces larger bone when it heals, but is weaker
    • Fracture risk, deformity
  • Specific area, not systemic
    • Pelvis, spine, skull, tibia (unilateral), etc.
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12
Q

List of things to think about for treatment of people with osteoporosis or Paget’s disease (7)

A
  1. Exercise–Stretching, strengthening, balance, weight bearing activity (30 min a day)
  2. Assistive device/bracing
  3. Sunlight- for vitamin D (ability to absorb decreases with age)
  4. Surgery- depending on degree of deformity
  5. Diet/Supplements
  6. Smoking- quit
  7. Alcohol consumption- moderation
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13
Q

Norms for T-scores (from Dexa scan)

A
  • -1 and above
    • Your bone density is considered normal
  • -1 and -2.5
    • Your score is a sign of osteopenia, a condition in which bone density is below normal and may lead to osteoporosis.
  • -2.5 and below
    • Your bone density indicates you likely have osteoporosis.
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14
Q

Points about treatment of vertebral fractures

A
  • It’s a mega bummer
  • Typically T-spine
  • Putting people into a brace which puts them into extension while Fx heals
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