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Flashcards in Osteoporosis Deck (40)
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0

Is osteoporosis often silent?

Yep.

1

Is just the density of the bone affected in osteoporosis?

No. Quality is decreased as well.

2

How many US men and women will have an osteoporosis-related fracture in their lifetimes?

1 in 2 women.
1 in 5 men.

3

What factor contributing to bone strength do we measure?

Density, with DXA.

4

Two main causes of low bone density late in life?

Low peak bone mass - never built it up.
Excess loss.

5

4 lifestyle factors that contribute to osteoporosis?

Low calcium intake
Vitamin D deficiency
EtOH intake > 3 drinks/day
Low BMI

6

2 significant genetic risk factors for osteoporosis?

Family Hx of hip fractures.
Idiopathic Hypercalciuria

7

3 endocrine disorders that contribute to osteoporosis?

Hypothalamic Amenorrhea
Hyperparathyroidism
Thyrotoxicosis
(there are many others - Cushing's, DM, hyperprolactinemia, etc.)

8

Main GI disease to screen for related to osteoporosis?

Celiac

9

Most important (according to highlighting) hematologic disorder related to osteoporosis?

Multiple myeloma.

10

Why does end stage renal disease (ESRD) contribute to osteoporosis?

Impaired Vitamin D activation.

11

Does rheumatoid arthritis contribute to osteoporosis?

Yeah.

12

5 medications that cause osteoporosis?

Anticonvulsants
PPIs
Aromatase inhibitors
Depo-medroxyprogesterone
Glucocorticoids

13

Osteoporosis diagnosis is only given to what demographic?

Post-menopausal women.
Men over age 50.

14

What part of the DXA scan results matters for osteoporosis diagnosis? What is the cut-off for diagnosis of osteoporosis?

T-score
Cut-off = -2.5

15

What is the T-score in DXA scans?

Number of standard deviations away from average bone density of young adults.

16

What is the Z-score in DXA scans?

# of standard deviations away from average bone density of age-matched controls.

17

What areas are usually scanned in DXA?

Lumbar spine, total hip, femoral neck (and sometimes forearm).

18

What T-scores for DXA are in the normal range?

-1 to 1

19

What's a T-score of -1 to -2.5 called?

Osteopenia.

20

What gives a osteoporosis diagnosis a designation as "severe"?

Having had a fracture.

21

How can you diagnose osteoporosis without a DXA scan?

History of "low-trauma" fracture.

22

Do the majority of fractures happen in people with osteoporosis?

No. (hip fractures in women do, though)
(...is this just because there are more people with osteopenia and normal bone density???)

23

7 risk factors in the Fracture Risk Assessment Tool (FRAX)?

Previous fracture
Age
Family Hx of osteoporotic fracture
Smoking
Low BMI
Alcohol
Glucocorticoids

24

What's the main utility of FRAX?

To decide if people in the "osteopenic" (i.e. not quite osteoporosis) category should get treatment.

25

3 reasons why you would pharmacologically treat post-menopausal women and men over 50?

DXA scan T score of -2.5 or less.
History of hip or spine fracture.
FRAX score >20% for all fractures or >3% for hip fracture.

26

4 non-pharm treatment to reduce fracture risk?

Reduce risk factors.
Take calcium and Vitamin D.
Exercise.
Reduce fall risk.

27

What are the 2 mechanisms by which bone density increasing drugs work?

Inhibiting osteoclast activity.
Increasing osteoblast activity.

28

What's the one drug that works to stimulate osteoblasts?

Teriparatide (recombinant PTH)

29

5 drugs that inhibit osteoclast activity?

Bisphosphonates
Denosumab
Calcitonin
Selective estrogen receptor modulator (SERM)
Estrogen