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)
Loading flashcards...

What is Osteoporosis:

Poris bone and reduced bone mass


What is the cause of Osteoporosis?

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


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.



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


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


What does DEXA scan stand for?

Dual Energy X ray absorptiomety


Normal bone density:

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



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



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


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.


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

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


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

Dual Energy X ray absorptiomety


What can osteoperosis in the spine lead to?

Kyphosis or a dowager’s hump.


what is a Dowagers hump?

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


What are some known factors that lead to osteoperosis?

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


Primary Type 2- Age related loss AKA senile Osteoporosis

Primary Type 2- Age related loss AKA senile Osteoporosis


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


What are the Other causes of senile Osteoporosis?

Reduced physical activity- Mechanical forces stimulate bone remodeling


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

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


Genetic factors leading to Osteoporosis

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


How can ones Nutritional state lead to Osteoporosis?

decreased vit d or Ca


What are the Ca+ intake recommendations?

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


What are the Vit D intake recommendations?

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


•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


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

Nmol/L or ng/ml


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!


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.


Vitamin D can be obtained by the sun, how?

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


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.


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

10 ng/ml.