Bone Disorders Flashcards
osteoporosis definition
most common metabolic bone disease
bone mineral density T score < -2.5
osteoporosis risk factors
age > 50 thin weight < 154 low dietary calcium vit D deficiency tobacco or etoh use corticosteroids or anticonvulsants
contributors to osteoporosis
bone remodeling
bone reabsorption - releases Ca+ into circulation by osteoclasts
bone formation - osteoblasts lay down osteiod
steroid use - causes osteoblast death and prolongs life of osteoclasts
decreased estrogen and testosterone levels lead to increased metabolism of Vit D
more contributors
chronic opioid use chemotherapeutic agents anticoagulants anticonvulsants excessive thyroid hormone immunosuppresants
osteoporosis screening
women > 65
younger with increased risk factors
osteoporosis labs
vit D 25 serum calcium intact PTH TSH 24 hour urine calcium biochemical markers of bone turn over
osteoporosis verus osteopenia
bone mineral density T score between -1 and -2.5 = osteopenia
equal to or less than -2.5 is osteoporosis
osteoporosis prevention: calcium recommendations
men 50 - 70 years 1000 mg of calcium a day
women > 50 - 1200 mg of calcium a day
osteoporosis prevention: vit D
all adults > 50
Vitamin D : 800-1000 iu daily
osteoporosis prevention
regular weight bearing exercises walking joggin tai chi stair climbing dance tennis regular muscle strengthening exercises yoga pilates
osteoporosis tx:
bisphosphonates
prevent and tx postmenopausal OP:
- Fosamax
- Boniva
- Actonel
- Reclast
glucocorticoid induced OP (men and women)
- Fosamax
- Actonel
- Reclast
calcitonin
nasal spray
NOT indicated for PREVENTION
small increase in bone mass
tx continued
RANK ligand
PTH
selective Estrogen Receptor Modulator
= prevent and tx postmenopausal OP
=vertebral fracture reduction only
=increased risk of venous thrombosis and fatal stroke
HRT
only for PREVENTION of postmenopausal OP
Paget’s Disease
2nd most common metabolic bone disease in older adults
by age 80, 1 in 10 is affected by the disease
localized increase in bone turnover and blood flow increase number, size, and activity of osteoclasts - causing break down of bone. osteoblasts keep up with tunover - leading to new disorganized bone
monstotic or polyostotic
paget’s pain
bone pain
deep ache
worse with heat
pelvis, femur, tibia, spine, and skull are most commons sites
