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ENDO 2 > bone disorders > Flashcards

bone disorders Flashcards

1
Q

osteomalacia

A

abnormal bone mineralization in MATURE bone

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2
Q

most common cause of osteomalacia

A

vitamin D deficiency

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3
Q

sx of osteomalacia

A

bone pain and tenderness
muscle weakness
increased fracture risk

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4
Q

how is osteomalacia diagnosed

A

low BMD on DXA scan + clinical symptoms!

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5
Q

what is osteopenia

A

bone density lower than usual for their age (but not to the point of osteoporosis)

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6
Q

osteopenia results on DXA

A

T score between -1.0 and -2.4

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7
Q

what is osteoporosis

A

low bone mass &/or micro-architectural changes that lead to bone fragility and increased risk of fracture

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8
Q

how bone remodeling causes osteoporosis

A

most times its caused by bone remodeling becoming uncoupled– Bone resorption outpaces formation

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9
Q

factors that can cause failure to achieve peak bone mass

A

genetics
childhood calcium intake
vit D status
physical activity

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10
Q

what is the most common type of osteoporosis encountered in clinic?

A

postmenopausal osteoporosis

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11
Q

etiology behind postmenopausal osteoporosis

A

accelerated bone turnover uncoupled

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12
Q

two ways of treating osteoporosis

A

decrease bone resorption by inhibiting osteoclasts with antiresorptive agents
stimulate bone formation by stimulating osteoblasts with anabolic agents

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13
Q

what are the two goals of therapy with osteoporosis?

A

prevent bone loss
prevent fractures

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14
Q

who should be treated with osteoporosis?

A

ppl with rapid bone loss (ie. getting glucocorticoid tx)
ppl at high risk of fracture (osteoporosis on DXA or hx of low-trauma fracture or elevated risk based on FRAX)

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15
Q

what is the most common osteoporotic fracture?

A

vertebral fracture

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16
Q

which type of fracture carries 20% 1 yr mortality and high morbidity?

A

hip fractures

17
Q

which type of fracture is more common in younger women? what is the mechanism of injury?

A

distal radius fracture
FOOSH injury

18
Q

what is secondary osteoporosis?

A

osteoporosis d/t identifiable RF (not age and menopause)

19
Q

what are the 3 identifiable RF associated with secondary osteoporosis?

A

glucocorticoids
endocrine d/o
malignancies

20
Q

how do glucocorticoids cause osteoporosis?

A

bad for bone health– decreases intestinal Ca absorption, increases RANKL, suppresses osteoblasts, increases renal Ca and phos loss
increased fracture risk even on low doses for short period

21
Q

what endocrine d/o are associated with secondary osteoporosis?

A

low testosterone
hyperparathyroidism!!!

22
Q

what malignancies are associated with secondary osteoporosis?

A

multiple myeloma
other lymphoproliferative malignancies

23
Q

how is osteoporosis diagnosed?

A

low-trauma fracture w/o alternative fracture is enough regardless of BMD testing!
if no fracture– DXA

24
Q

what 3 parts of the body is DXA for?

A

lumbar spine
hip
forearmT

25
Q

T vs Z score

A

both: how many SD from mean of populatoin
T score– sex-matched healthy controls including young
Z score– sex matched + age-matched

26
Q

what does a T score of 0 mean?

A

same BMD on average

27
Q

what two populations is the T score most useful for?

A

postmenopausal women
men over 50yo

27
Q

T score of -2.5 means

A

osteoporosis

28
Q

what populations is the Z score for?

A

premenopausal women
young men

29
Q

why is the Z score not used in older population?

A

just because a 90 yo bones are average for their age group doesn’t mean its normal

30
Q

what does a Z score less than -2.0 mean?

A

“lower than expected bone density for age”

31
Q

can you make a dx of osteoporosis in younger person with DXA results alone?

A

NO
in the younger age group, only dx osteoporosis if there is fragility fracture

32
Q

why should osteopenia never be diagnosed in young healthy population?

A

bc some young healthy people will have BMD >1SD below mean (T score of 1.0) but doesn’t mean their bone density is pathologically low

33
Q

risk factors for osteoporosis

A

female
increasing age
postmenopausal status/testosterone deficiency
low weight
smoking
family hx

34
Q

what is the strongest RF for future fragility fracture?

A

previous fragility fracture!
should implement aggressive risk reduction

35
Q

two risk factors for falls/fractures

A

poor muscle strength
impaired balance or vision

36
Q

risk factors for osteomalecia (online)

A

Less sun exposure/Vit D deficiency
Diet.
Dark skin.
Obesity.
Elderly.
Renal or hepatic disease.
Malabsorptive syndromes.

ENDO 2 (6 decks)

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