Patho: Exam 2 Osteoporosis/Pagets Disease/Hyperparathyroidism Flashcards Preview

Clinical Medication: HEENT > Patho: Exam 2 Osteoporosis/Pagets Disease/Hyperparathyroidism > Flashcards

Flashcards in Patho: Exam 2 Osteoporosis/Pagets Disease/Hyperparathyroidism Deck (84)
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1

What is Osteoporosis:

Poris bone and reduced bone mass

2

What is the cause of Osteoporosis?

There are multiple causes ( Senile- primary type 2, Postmenopausea- primary type 1, Secondary)

3

What are some causes of secondary Osteoporosis?

Endocrine- Cushing disease, Neoplastic- Multiple myloma eating away at the bone, GI- any malabsorption of calcium, Drugs- steroids decrease calcium absorption and misc.

4

Stats

in the Unitied states 15% of people by the age of 80 have a hip fracture, 25% by age 90 have hip fracture.

5

Pathology of Osteoporosis

Decreased thickness of cortex
Reduction in number and size of trabeculae of cancellous bone

Type 1(postmenopausae): disrupted connections between trabeculae- increased osteoclast activity.

Type 2(senile): reduced trabecular thickness- loss of osteoblast activity

6

What does DEXA scan stand for?

Dual Energy X ray absorptiomety

7

Normal bone density:

Normal: Bone Mineral Density no lower than 1 SD below mean for young adult women: T>-1

8

Osteopenia

(Low bone mass): BMD 1.0-2.5 SD below the mean for young adults (T=-1 to -2.5)

9

Osteoporosis

BMD more than 2.5 SD below young adult mean (T<-2.5)

10

What is T versus Z score

T score- refers to the average bone density of a 30 y/o female

Z score- age and gender match.

11

Who needs to get a dexa scan?

Women >65, Men >70
If you break a bone after the age of 50
Women of menopausal age with risk factors
Man age 50-69 with risk factors

Other:
An xray showing bone loss
Back pain with possible break in spine
Height loss > .5 in or more in one year
Total heigh loss of greater than 1.5 in. from original

12

What is the most common location they look at on DEXA?

Dual Energy X ray absorptiomety

13

What can osteoperosis in the spine lead to?

Kyphosis or a dowager’s hump.

14

what is a Dowagers hump?

the type of kyposis seen in osteoporosis due to shorter vertebral does in the spine

15

What are some known factors that lead to osteoperosis?

oHereditary factors
oPhysical activity
oMuscle strength
oDiet
oHormonal state
oAge related loss: 0.5% -0.7%/year

16

Primary Type 2- Age related loss AKA senile Osteoporosis

Primary Type 2- Age related loss AKA senile Osteoporosis

17

What is the problem in senile Osteoporosis

Reduced poligeration of the Osteoblast –they become sluggish

Proteins bound to matrix (Growth factors) lose biologic activity (Beta Catenin_)

Net result: decreased compasity to make bone

Both Trabecular and cortical bone is decreased

18

What are the Other causes of senile Osteoporosis?

Reduced physical activity- Mechanical forces stimulate bone remodeling

19

What evidence supports physical activity reduction leading to low bone density?

o Immobilized extremity
o Astronauts in zero gravity
oAthletes have higher bone density

20

Genetic factors leading to Osteoporosis

o Associated genes: RANK ligand, OPG, RANK
o Other implicated genes: Vit D receptors, LPR5, Estrogen receptor gene.

21

How can ones Nutritional state lead to Osteoporosis?

decreased vit d or Ca

22

What are the Ca+ intake recommendations?

o Adults under 50- 1,000 mg/day
o Adults over 50-1,200 mg/day

23

What are the Vit D intake recommendations?

o Adults under 50- 400-800 IU
o Adults over 50- 800-`1000IU

24

•What type of vit D should you order?

o Calcidiol- 25 hydroxyvitamin D not 125, because 125 has a short ½ life and wont give you a good reading

25

There are two types of measurement on lab what are they?

Nmol/L or ng/ml

26

What are the deficent, inadequate, adequate and bad levels of Vit D

o 50 nmol/L (> 30 ng/ml)= adequate
o >125nmol/L (>50 ng/ml)=bad- tooMUCH!

27

what is a side effect of taking to much Calcium?

The Ca+ suppliments are like candy, so people where taking in so much Ca+ but the side effect of SPIKED ca+ ( random increases) will lead to depositis of ca+ athrosclerosis in the vessels – new recommendations is just to get Ca in the diet.

28

Vitamin D can be obtained by the sun, how?

You need to spend 20 min in direct sunlight in the peak sun light everyday.

29

What are the two types of vit d and what is the difference between them?

D3: Cholecalciferol- what you actually make ( needs to go to the liver to become a hormone)

D2: Ergocalciferol

D3 has a longer half life.

30

For every 1000 units per day, after 1 mo, how much will it raise your vit D?

10 ng/ml.