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Flashcards in Rheum - Osteoporosis Deck (13):
0

Biphosphonates – names? mechanism of action? Adverse effect?

Alendronate, risedronate, ibandronate

Synthetic carbon phosphate compounds that bind to pyrophosphate and inhibit osteoclastic bone resorption

Severe esophagitis (caution in patients with gastric reflux)

1

Osteopenia definition?

T score between -1.0 and -2.5 standard deviations below the mean of young healthy adults

T score More than -2.5 standard deviations below the mean of young healthy adults

2

Risk factors for osteoporosis?

1. Low peak skeletal density
2. Increasing age
3. Loss of steroid hormone production (menopause or hypogonadism)
4. Smoking
5. Nutritional deficiencies

3

Most common cause of secondary osteoporosis?

Glucocorticoid excess (from treatment for diseases like rheumatoid arthritis)

4

Endocrine Pathologies that will lead to osteoporosis?

1. Gonadal deficiency (female athletes or anorexics)
2. Hyperprolactinemia
3. Hyperparathyroidism
4. Hyperthyroidism

5

Medications that accelerate bone loss?

Cyclosporine, antiepileptics, heparin, GnRH inhibitors

6

When are women recommended to undergo bone mineral density (BMD) testing?

1. All Women >65 years
2. women <65 years who have sustained a fracture

7

DEXA scan: Z score versus T score

Compares bone density to patient of the same age versus young healthy adult

8

Osteomalacia?

Vitamin D or phosphate deficiency that results in an accumulation of unmineralized osteoid

9

Pagent disease?

Disorganize bone remodeling with high alk phos

10

Treatment of osteoporosis?

1. 1000 to 1200 mg of calcium daily
2. 400 to 800 IU of vitamin D
3. Biphosphonates
4. estrogen (depending)
5. Weight-bearing activity
6. Raloxifene - SERM that decreases breast cancer risk and LDL
7. Teriparatide - parathyroid analogue that stimulates bone matrix formation

11

Effect of biphosphonates on incidence of fractures?

Decreases incidence of hip fractures by 30 to 50%

12

Bisphosphonates are rarely associated with what complication?

Osteonecrosis of the jaw

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