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Flashcards in Rheum - Osteoporosis Deck (13)
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0
Q

Osteopenia definition?

A

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

1
Q

Biphosphonates – names? mechanism of action? Adverse effect?

A

Alendronate, risedronate, ibandronate

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

Severe esophagitis (caution in patients with gastric reflux)

2
Q

Risk factors for osteoporosis?

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

Most common cause of secondary osteoporosis?

A

Glucocorticoid excess (from treatment for diseases like rheumatoid arthritis)

4
Q

Endocrine Pathologies that will lead to osteoporosis?

A
  1. Gonadal deficiency (female athletes or anorexics)
  2. Hyperprolactinemia
  3. Hyperparathyroidism
  4. Hyperthyroidism
5
Q

Medications that accelerate bone loss?

A

Cyclosporine, antiepileptics, heparin, GnRH inhibitors

6
Q

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

A
  1. All Women >65 years

2. women <65 years who have sustained a fracture

7
Q

DEXA scan: Z score versus T score

A

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

8
Q

Osteomalacia?

A

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

9
Q

Pagent disease?

A

Disorganize bone remodeling with high alk phos

10
Q

Treatment of osteoporosis?

A
  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
Q

Effect of biphosphonates on incidence of fractures?

A

Decreases incidence of hip fractures by 30 to 50%

12
Q

Bisphosphonates are rarely associated with what complication?

A

Osteonecrosis of the jaw

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