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KCEP 210 Final exam > 9 - Osteoporosis > Flashcards

9 - Osteoporosis Flashcards

1
Q

Can osteoporosis occur in young adults?

A

Yes

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2
Q

The use of which medications can lead to osteoporosis?

A

All the medications that are used to decrease inflammation

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3
Q

Definition of osteoporosis

A

Metabolic disease of the bones

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4
Q 
Osteo = ?
Porosis = ?
A

= bone

= porous (cavities in the bone)

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5
Q

Osteoporosis diagnosis: BMD measurement - Dual-energy X-ray absorptiometry (DEXA)

A

Scans the entire body and measures the risk for fracture in the hip, spine, and wrist

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6
Q

Level of radiation of DEXA + type of image provided

A

Low and the test takes less than 5 min

Provides 2-D images of successive bone layers

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7
Q

BMD

A

Bone mineral density

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8
Q

Osteoporosis diagnosis: BMD measurement - Quantitative computed tomography (QCT)

A

Measure BMD in the hip and spine and produces a 3-D image that shows true volume density QCT. Can isolate area for testing

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9
Q

Level of radiation for QCT

A

10 times higher than DEXA

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10
Q

QCT is the only method capable of distinguishing BMD level between ___ and ___

A

the exterior cortical bone

the interior trabecular bone

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11
Q

Trabecular bone =

A

where the bone loss begins

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12
Q

BMD measurement is give as a ___ and a ____

A

T-score

Z-score

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13
Q

T-score

A

the deviation from the mean bone density of healthy young adults of the same gender and ethnicity

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14
Q

Z-score

A

the deviation from the mean bone density of adults of the same age. gender and ethnicity

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15
Q

WHO score for osteoporosis

A

A T-score of -2,5 S.D and below

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16
Q

WHO score for osteopenia

A

A T-score between -1 S.D and -2,5 S.D

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17
Q

If BMD of healthy young adults for the hip is 1000 +/- 100 S.D (mg/cm2), what is osteopenia and what is osteoporosis?

A 
Osteopenia = BMD of 900 to 750 mg/cm2
Osteoporosis = BMD of 750 or lower
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18
Q

What is established osteoporosis?

A

Preferred term for those with osteoporosis and having one or more fragility fractures

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19
Q

What is a fragility fracture?

A

Any fall from a standing height or less, resulting in a fracture

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20
Q

Most common areas of fragility (3)

A

Wrist, hips, spine

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21
Q

Every standard deviation below normal doubles the risk for fracture, so -1 S.D equals 2 times the risk, if -3 S.D ?

A

equals 8 times the risk of fracture

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22
Q

Z-score is used to determine what?

A

Whether the loss of bone density is secondary to another disease or condition

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23
Q

If the Z-score is ___ than expected for age, them there must be something accelerating this loss beyond the normal process of aging

A

Lower

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24
Q

Prevalence of osteoporosis in Canada (women vs men, race/sex difference, cost)

A

1 out of 4 women over the age of 50 is affected
1 out of 8 men over the age of 50 is affected
More women than men
Costs 4.6 billion per year

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25
Q

Why are women more affected than men?

A

Lack of hormones after menopause, women have smaller bones to start with which puts them at risk

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26
Q

Hip fractures and falls: Is the fall due to the femoral neck fracture or is the fracture the result of the fall?

A

The fracture is the result of the fall (80%)

27
Q

Most common fractures (3)

A

Vertebra, hip, wrist

28
Q

Over 60 years old, ___% fracture of vertebra

29
Q

Over 50 years old, ___% hip fracture

30
Q

Women aged 65-69 who break a hip are ___ times more likely to die within ___ than women of the same age who don’t break a hip

A

3 times

a year

31
Q

Slide 16, trend of the graph

A

Increase in osteopenia until reach age 80 because they they fall into the osteoporosis category (lowering of their BMD)

32
Q

To be considered in the established osteoporosis category, what 2 things to you need?

A

Fragility fracture + osteoporosis

33
Q

Bone remodeling happens every?

A

3 to 4 months

34
Q

Osteoclast

A

Bone eroding cells - dissolve the mineral and cause small cavities

35
Q

Bone resorption

A

Decalcification

36
Q

Osteoblast

A

Bone reforming cells - fill in the cavities until it is restored

37
Q

Bone formation

A

Calcification

38
Q

End product

A

New mineralized bones

39
Q

name the 2 aging effects

A
  1. unbalance in bone remodeling process

2. calcium is less efficiently absorbed

40
Q

Loss of __% of total bone mass each after year after the age of __ ( = peak)

A

1%

20 years old

41
Q

Loss of __ to __% of total bone mass each year in women after ___ (first 5 years)

A

2 to 3%

Menopause

42
Q

How can we positively change/influence the BMD slope? (3)

A

Better nutrition
Physical activity
Hormones in post-menopausal for women

43
Q

Bone remodeling process is under the control of: (2)

A
  1. Hormones

2. Mechanical loading (exercise)

44
Q

Role of hormones (bone remodeling process)

A

To maintain appropriate level of calcium in the bone

45
Q

Lack of hormones =

A

bone atrophy

46
Q

Role of mechanical loading (bone remodeling process)

A

Required to maintain adequate bone density

Loading = activation of bone cells = BMD (increase or maintain)

47
Q

Absence of loading =

A

bone atrophy

48
Q

Spongy bone

A

Where the degeneration occurs first

49
Q

Why is it that there is no spinal cord damage with most fracture on the spine?

A

Damages are limited to the front of the vertebral column

50
Q

The bony trabeculae are thinned out and the mechanical strength of the vertebra is reduced. This leads to (2)?

A

Compression fractures and flattening of the vertebra

51
Q

Factors beyond your control - Direct effect on bone remodeling process (4)

A

Menopausal
Prolonged hormonal imbalances (thyroid gland)
Removal of ovaries or premature menopause (before age 45)
Prolonged use or heavy doses of certain medications

52
Q

Factors you can control (5)

A 
Lack of physical exercise
Diet poor in calcium and vitamin D
Smoking
Caffeine
Excessive consumption of alcohol
53
Q

Classification (3)

A
  1. Postmenopausal Osteoporosis (type 1)
  2. Senile Osteoporosis (type 2)
  3. Secondary osteoporosis
54
Q
  1. Postmenopausal osteoporosis (type 1)
A

Decrease estrogen = decrease 10-15% BMD in the first 5 years
Only women
Vertebral and hip fractures

55
Q

Most common classification

A

Postmenopausal osteoporosis

56
Q
  1. Senile osteoporosis
A

Over 80 years
30% are men
Forearm, pelvic and hip fractures

57
Q
  1. Secondary osteoporosis
A

Associated with calcitonin imbalance, malabsorption conditions, alcoholism, smoking and the use of certain medications

58
Q

Prevention technique

A

Hormone replacement therapy (estrogen)

59
Q

Pros of hormone replacement therapy

A

Inhibit or slow bone bone resorption

Decrease effects of menopause

60
Q

Cons of hormone replacement therapy

A

Increase risk of blood clots, stroke and coronary heart disease
Necessary or not?

61
Q

Best kind of physical activity for prevention (2)

A
  • Weight-bearing activities

- Resistance exercise

62
Q

Special consideration for exercise for intensity

A

High intensities and few repetitions to increase bone pressure

63
Q

Effects of exercise on the bones

A

Increase pressure on the bone = increase bone mass

64
Q

Special considerations to exercise for people with osteopenia/osteoporosis

A
  • Avoid forward flexion of the spine
  • Adapt equipment for decrease risk of falling
  • Aerobic dance exercise = low impact
  • Resistance training = decrease load and increase repetitions

KCEP 210 Final exam (8 decks)

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