bone disorders Flashcards

(37 cards)

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
T vs Z score
both: how many SD from mean of populatoin T score-- sex-matched healthy controls including young Z score-- sex matched + age-matched
26
what does a T score of 0 mean?
same BMD on average
27
what two populations is the T score most useful for?
postmenopausal women men over 50yo
27
T score of -2.5 means
osteoporosis
28
what populations is the Z score for?
premenopausal women young men
29
why is the Z score not used in older population?
just because a 90 yo bones are average for their age group doesn't mean its normal
30
what does a Z score less than -2.0 mean?
"lower than expected bone density for age"
31
can you make a dx of osteoporosis in younger person with DXA results alone?
NO in the younger age group, only dx osteoporosis if there is fragility fracture
32
why should osteopenia never be diagnosed in young healthy population?
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
risk factors for osteoporosis
female increasing age postmenopausal status/testosterone deficiency low weight smoking family hx
34
what is the strongest RF for future fragility fracture?
previous fragility fracture! should implement aggressive risk reduction
35
two risk factors for falls/fractures
poor muscle strength impaired balance or vision
36
risk factors for osteomalecia (online)
Less sun exposure/Vit D deficiency Diet. Dark skin. Obesity. Elderly. Renal or hepatic disease. Malabsorptive syndromes.