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1

living bone is constantly being

remodeled

2

bones are close to homeostatic equilibrium between

bone formation and bone resorption

3

16-20s bone mass

bone resorption > bone formation w age

due to calcium metabolism, vitamin D deficiency, and/or hormonal factors, such as changes of estrogen level

4

Measuring proteins produced by the _____ provides a real-time evaluation of bone turnover

osteoblasts and osteoclasts

5

disrupts bone tissue

osteoclasts

6

hyperactivty of this casses osteoporsis

osteoclasts

7

produces new bone tissue

osteoblasts

8

metabolic bone diseases are a spectrum of disorders caused by abrnormal levels of

minerals (ca, phos, magn, vit D)

9

Disorders of bone strength related to bone mass or structure:

osteoporsis + osteopenia

10

most common metabolic bone disorder is (“silent thief as you age”)
untreated, can lead to fragility fractures, bone deformities and serious disability

osteoporosis

11

condition common to all metabolic bone diseases; not a diagnosis but term used to describe loss of bone density
refers to bone mineral density (BMD) that is lower than normal peak BMD; not as low as osteoporosis

osteopenia

12

stats on osteopenia and osteoporosis

Cause, generally unknown
As many as 10 million Americans have osteoporosis
34 million more have osteopenia (low bone density)
Bone density peaks at about age 30

13

women can lose up to __% of their bone density 5 years after menopasuce

20%

14

two types of osteoporosis

primary and secondary

15

age-related bone loss (called senile osteoporosis)
or cause is unknown (idiopathic osteoporosis – term used only for men younger than 70 years old)

primary osteoporsis

16

caused by certain lifestyle behaviors diseases, or medications
smoking, excessive alcohol, immunosuppressive drugs, COPD, immobilization, etc.

secondary osteoporsis

17

osteoporsis diagnostic work up

medical history, x-rays, and urine and blood tests
bone mineral density (BMD) test (dual-energy x-ray absorptiometry or Dexa)
other tests - includes ultrasound and QCT

18

Reading Dexa Results

T score numbers and Z score numbers

what is bone mineral density?

Bone mineral density (BMD) = the number of grams per centimeter of bone. Numbers 1.0 or above are good.
T score shows how your bone mineral density compares with women in their thirties
-1 through -2.5 indicate osteopenia
< -2.5 indicate osteoporosis
Z score compares your bone mineral density with others of your own age

19

osteoporosis risk factors

highest-risk groups include older women and those who have gone through menopause

estrogen levels decrease, bones lose calcium and other minerals at a faster rate
bone loss of approximately 2% per year occurs for several years after menopause
Men also lose bone as they age, however testosterone levels decline gradually so bone mass remains adequate longer

20

Uncontrollable osteoporsis risk factors:

Family history – bone health can be strongly inherited
Being female
Menopause
Low body weight (small/thin)
Coeliac disease, inflammatory bowel disease (malabsorption)

21

Controllable osteoporosis risk factors:

Low calcium intake
Low vitamin D levels
Inactive, sedate lifestyle
Smoking, excessive alcohol
Weight loss

22

Other Osteoporosis Risk Factors

Vitamin D deficiency
Dark skin pigmentation
Environmental causes
Lead
Housebound, frail elderly, malabsorption

23

Osteoporosis Prevention in kiddos

Children and adolescents should:
Ensure a nutritious diet with adequate calcium intake
Avoid protein malnutrition and under-nutrition
Maintain an adequate supply of vitamin D
Participate in regular physical activity, exercise regularly
Avoid the effects of second-hand smoking

24

Osteoporosis Prevention in adults

Ensure a nutritious diet and adequate calcium intake
Avoid under-nutrition, particularly the effects of severe weight-loss diets and eating disorders
Maintain an adequate supply of vitamin D
Participate in regular weight-bearing activity
Avoid smoking and second-hand smoking
Avoid heavy drinking

25

Bone mineral density (BMD) tests recommended for

All women aged 65 years or older and men aged 70 years or older
Younger postmenopausal women and men aged 50-70 years with clinical risk factors for fracture
Women in menopausal transition with a risk factor for fractures (low body weight, prior low-trauma fracture, use of a high-risk medication)
Adults with fragility fractures
Adults who have a condition associated with low bone mass or bone loss (e.g., rheumatoid arthritis)
Adults on medication associated with low bone mass or bone loss (glucocorticoids, ≥5 mg of prednisone daily for > 3 mo)

26

Hyperparathyroidism
Paget’s diseases of the bone (osteitis deformans)
Fragility
Parathyroid disorders
Vitamin D deficiency
Osteomalacia
Rickets
Calcium and phosphorus disorders
Renal osteodystrophy

Other metabolic bone disorders

27

means trouble w flow in patient's body

rheumaticus

28

rheumatic diseases are what kinda of disease?

autoimmune and inflammtory diseases

(immune system attachs person's joints, muscles, bones, and organs)

29

women are how many more times likely to develop RA?

2-3x

30

women are how many more times likely to develop lupus?

10x