10 minute topic Osteoporosis Flashcards
Osteoblast cells
responsible for bone formation
Osteoclast cells
function in bone re-absorption
Osteopenia
low bone mineral density
precursor to osteoporosis
Time of peak bone density
18-35
Foods rich in vitamin D
fish, egg yolks, fortified milk, and cereal
Foods rick in calcium
milk products, green vegetables, fortified orange juice and cereals, red and white beans, and figs
Risk factors for osteoporosis
Female > 60 years (> 75 in men) Post-menopausal estrogen deficiency Oral contraceptive use Large intake of caffeinated or carbonated beverages Tall, thin, lean body type High alcohol intake Smoker
Secondary causes of osteoporosis
long term corticosteroid use
hyperparathyroidism
calcium and vitamin D supplements
take with food
Medications for Osteoporosis
HRT Selective estrogen receptor modulators Ca and vit D supplement Bisphosphonates Thyroid hormone
HRT
Premarin
possible breast and endometrial cancers
DVT
estrogen and progesterone need to be given to women who still have uterus
Selective Estrogen Receptor Modulators
raloxifene hydrochloride (Evista)
Decrease osteoclasts
Do not use in hx of DVT
Monitor LFT’s
What to monitor with Ca supplement
kidney stones
Absorption of vit D
fat saluble
toxicity sx include nausea, constipation and kidney stones
Bisphosphonates
alendronate (fosamax), ibandronate (boniva), risedronate (Actonel)
Decreases osteoclasts
Monitor output, drug can be toxic to kidneys
Take w/ 8 oz. of water early morning before eating
Remain upright for 30 min
Thyroid hormone
calcitonin human, calcitonin salmon (Miacalcin, fortical) – this may be given if the osteoporosis is related to hyperparathyroidism
Inhibit osteoclast activity
Calcitonin salmon administered subq, im, and intranasally
Osteoarthritis
deterioration of the articular cartilage
noninflammatory (unless localized), and nonsystemic disease
Osteoarthritis sx
joint pain improved with rest localized inflammatory response pain on palpation crepitus enlarged joint or nodes
Osteoarthritis Dx
x-ray or CT
Osteoarthritis teaching
use joint saving measures, maintain healthy wt
Osteoarthritis risk factors
>55yrs Female Obesity Possible genetic link Hx of repetitive stress on joints
Labs for Osteoarthritis
Increase in ESR
HS (high sensitivity) C-reactive protein increased slightly
No change in ANA (only seen in RA)
Paget’s disease
A chronic metabolic disorder where bone is excessively broken down and reformed. Bone matrix is structurally disorganized resulting in bone weakness with increased risk of bowing of long bones and fractures.
Types of Paget’s disease
familial or sporadic
Paget’s disease tx
no real tx
offer support of sx
Osteomalacia
A loss of bone related to vitamin D deficiency caused by inadequate deposits of calcium and phosphorus in the bone matrix.
Called Rickets in children
Causes soft bone
Osteomalacia tests
Vitamin D levels
Bone biopsy
X-ray
ALP (alkaline phosphatase) isoenzyme or PTH to ckeck for underlying kidney problem
Osteomalacia prognosis
Improvement seen within a few weeks in some
Complete healing within 6 months.
