10 minute topic Osteoporosis

Question 1

Osteoblast cells

Answer 1

responsible for bone formation

Question 2

Osteoclast cells

Answer 2

function in bone re-absorption

Question 3

Osteopenia

Answer 3

low bone mineral density

precursor to osteoporosis

Question 4

Time of peak bone density

Answer 4

18-35

Question 5

Foods rich in vitamin D

Answer 5

fish, egg yolks, fortified milk, and cereal

Question 6

Foods rick in calcium

Answer 6

milk products, green vegetables, fortified orange juice and cereals, red and white beans, and figs

Question 7

Risk factors for osteoporosis

Answer 7

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

Question 8

Secondary causes of osteoporosis

Answer 8

long term corticosteroid use

hyperparathyroidism

Question 9

calcium and vitamin D supplements

Answer 9

take with food

Question 10

Medications for Osteoporosis

Answer 10

HRT
Selective estrogen receptor modulators
Ca and vit D supplement
Bisphosphonates
Thyroid hormone

Question 11

HRT

Answer 11

Premarin
possible breast and endometrial cancers
DVT
estrogen and progesterone need to be given to women who still have uterus

Question 12

Selective Estrogen Receptor Modulators

Answer 12

raloxifene hydrochloride (Evista)
Decrease osteoclasts
Do not use in hx of DVT
Monitor LFT’s

Question 13

What to monitor with Ca supplement

Answer 13

kidney stones

Question 14

Absorption of vit D

Answer 14

fat saluble

toxicity sx include nausea, constipation and kidney stones

Question 15

Bisphosphonates

Answer 15

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

Question 16

Thyroid hormone

Answer 16

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

Question 17

Osteoarthritis

Answer 17

deterioration of the articular cartilage

noninflammatory (unless localized), and nonsystemic disease

Question 18

Osteoarthritis sx

Answer 18

joint pain improved with rest
localized inflammatory response
pain on palpation
crepitus
enlarged joint or nodes

Question 19

Osteoarthritis Dx

Answer 19

x-ray or CT

Question 20

Osteoarthritis teaching

Answer 20

use joint saving measures, maintain healthy wt

Question 21

Osteoarthritis risk factors

Answer 21

>55yrs
Female
Obesity 
Possible genetic link
Hx of repetitive stress on joints

Question 22

Labs for Osteoarthritis

Answer 22

Increase in ESR
HS (high sensitivity) C-reactive protein increased slightly
No change in ANA (only seen in RA)

Question 23

Paget’s disease

Answer 23

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.

Question 24

Types of Paget’s disease

Answer 24

familial or sporadic

Question 25

Paget’s disease tx

Answer 25

no real tx

offer support of sx

Question 26

Osteomalacia

Answer 26

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

Question 27

Osteomalacia tests

Answer 27

Vitamin D levels
Bone biopsy
X-ray
ALP (alkaline phosphatase) isoenzyme or PTH to ckeck for underlying kidney problem

Question 28

Osteomalacia prognosis

Answer 28

Improvement seen within a few weeks in some

Complete healing within 6 months.