osteoporosis

Question 1

osteoporosis patho

Answer 1

porous bone, more common in women

• women tend to have lower ca levels
• less bone mass due to smaller frame
• bone resorption(ca leaving bone) begins at early age accelerated in menopause
• pregnancy & breastfeeding deplete Ca
• longevity increases liklihood

Question 2

osteoporosis risk factors

Answer 2

-female
-increased age
-family history
-caucasian
-asian
-small stature
-early menopause decreased estrogen
-history of anorexia/malnutrition
-oophorectomy/no estrogen
-sedentary lifestyle
insufficient ca
cigarettes, smoking, alcoholism, low t in men
-medications/corticosteroids, thyroid,heparin,long acting sedatives, anti seizure meds, depo-provera

Question 3

S/S of osteoporosis

Answer 3

fracture, loss of height or spinal deformities (kyphosis)

Question 4

diagnosis of osteoporosis

Answer 4

BMD(bone mineral density)

Dexa scan scores are T-scores

Question 5

T-score values

Answer 5

normal is >-1.0
osteopenia is -1.0 to -2.5
osteoporosis is > -2.5

Question 6

Treatment of osteoporosis

Answer 6

• vitamin D & calcium supps
• weight bearing exercise
• estrogen replacement (most beneficial 1st 10 years)
• Calcitonin secreted by the thyroid gland & inhibits bone resorption keeps ca in the bone

Question 7

treatment of osteoporosis w/biphosphonates

Answer 7

alendronate /Fosamax, risedronate/actonel, ibandronate/boniva

• take w/a full glass of water
• stay upright for 30 minutes
• take before food or other meds

Question 8

Treatment of osteoporosis w/SERMS

Answer 8

raloxifene/evista:mimic effects of estrogen on bone w/out stimulating breast or uterine tissue
SE:leg cramps, hot flashes, blood clots

Question 9

use of teriparatide/forteo to treat osteoporosis

Answer 9

forteo/teriparatide: portion of parathyroid
stimulates new bone formation
subq injection once a day
given for maximum of 2 years
SE:risk for osteosarcoma