BSI Lecture 49-50 Osteoporosis

Question 1

What is the normal serum osmolarity value?

Answer 1

290 mOsm/L

Question 2

T/F? Osteoporosis is the most common bone disorder.

Answer 2

True

Question 3

Osteoporosis is generalized in that it includes all of what?

Answer 3

Osteoporosis includes all of the bones of the skeleton.

Question 4

What are the two main characterizations of osteoporosis?

Answer 4

a) Loss of bone resulting from bone demineralization.

b) Increased brittleness due to decreased collagen.

Question 5

As defined by the WHO (World Health Organization), how many standard deviations below the peak bone mass is the BMD of someone with osteoporosis?

Answer 5

2.5

Question 6

What does BMD stand for?

Answer 6

Bone mass density

Question 7

What is BMD measured by?

Answer 7

DXA (dual energy x-ray absorptiometry)

Question 8

What is a T-score of >-1.0 considered?

Answer 8

normal

Question 9

What is a T-score of -1.0 to -2.5 considered?

Answer 9

Osteopenic

Question 10

What is a T-score of

Answer 10

Osteoporotic

Question 11

What is a T-score?

Answer 11

The number of standard deviations from the bone density that is normally expected in a healthy young adult of the same sex.

Question 12

What is a Z-score?

Answer 12

Your bone density compared with what is normally expected in a healthy adult of the same age and sex.

Question 13

There are many causes of osteoporosis, but what is the final common outcome?

Answer 13

A reduction in the bone mass below a critical level, which causes an increased susceptibility to fractures.

Question 14

What is the main difference between primary and secondary osteoporosis?

Answer 14

Primary osteoporosis is caused by cumulative bone loss.

Question 15

What is Type 1 osteoporosis?

Answer 15

Postmenopausal osteoporosis

Question 16

T/F? Type 1 osteoporosis is considered the most common type of osteoporosis.

Answer 16

True

Question 17

What is the cause of Type 1 osteoporosis?

Answer 17

A lack of oxygen

Question 18

Is type 2 primary or secondary?

Answer 18

Primary

Question 19

What is type 2 osteoporosis?

Answer 19

Senile osteoporosis

Question 20

What does type 2 osteoporosis deal with?

Answer 20

A decrease in the enzyme 1-alpha-hydroxylase

Question 21

What is the function of the enzyme 1-alpha-hydroxylase, and where is it located?

Answer 21

This is an enzyme located in the kidney that activates vitamin D.

Question 22

What type of osteoporosis falls under secondary osteoporosis?

Answer 22

Type 3

Question 23

What is type 3 most often caused from?

Answer 23

disease or drug therapy

Question 24

How many women and men over the age of 50 will experience an osteoporosis-related fracture?

Answer 24

1 in 2 women and 1 in 4 men

Question 25

By 2050, what is the estimated amount of hip fractures?

Answer 25

6.3 million

Question 26

How many people die within the first year after a hip fracture?

Answer 26

20%

Question 27

Why is osteoporosis considered a silent disease?

Answer 27

The first symptom is a fractured bone

Question 28

What area of bone is the area most affected? What are some examples of these bones?

Answer 28

Areas of bone with mostly spongy bone--The neck and femur are some examples.

Question 29

T/F? In severe cases, contraction of the muscle in daily activity can cause a fracture.

Answer 29

True

Question 30

What are common consequences of osteoporosis?

Answer 30

Pain, fear, isolation, depression, height loss, kyphosis

Question 31

What is kyphosis, and what is the most common side effect of the condition?

Answer 31

Hunchback, which can lead to a compression of internal organs.

Question 32

What may kyphosis restrict?

Answer 32

Lung function

Question 33

What are some digestive problems potentially caused as a result of kyphosis?

Answer 33

Loss of appetite, constipation, abdominal pain and distention, and weight loss which may lead to more frailty

Question 34

What are the risk factors for osteoporosis?

Answer 34

1. Low peak bone mass 2. Low calcium and vitamin D intake 3. Lack of exercise 4. Environmental factors 5. Aging 6. Low levels of estrogen

Question 35

What is the primary effect of osteoporosis?

Answer 35

Genetics

Question 36

What is the variance of peak bone mass accounted for by genetic factors?

Answer 36

80%, while the other 20% is accounted for by nutrition, exercise, and hormonal status

Question 37

What are the two main environmental factors?

Answer 37

Smoking and alcohol consumption of more than 3 drinks/day

Question 38

How does aging contribute to osteoporosis?

Answer 38

Loss of bone due to demineralization, and brittleness due to decreased synthesis of collagen.

Question 39

How do low levels of estrogens contribute to osteoporosis?

Answer 39

Loss of estrogen during menopause, which decreases osteoblast activity, and increased activity of osteoclasts.

Question 40

What are the targets of treatment for osteoporosis?

Answer 40

Treatment of fractures, management of pain from fractures, and pharmacologic therapies.

Question 41

How do bisphosphonates work to treat osteoporosis?

Answer 41

Bisphosphonates promote osteoclast apoptosis. In addition, they inhibit bone resorption by osteoclasts. they impair osteoclasts from forming a ruffled border by attaching to hydroxyapatite binding sites on bony surfaces.

Question 42

How does calcitonin work on osteoporosis?

Answer 42

Calcitonin inhibits the activity of osteoclasts.

Question 43

How does Denosumab work on osteoporosis?

Answer 43

It is an antibody that binds RANKL

Question 44

How does Recombinant PTH, such as Teriparatide, work on osteoporosis?

Answer 44

It activates osteoblasts more than osteoclast, which leads to an overall increase in bone. It is identical to a portion of human PTH.

Question 45

How do estrogen and selective estrogen receptor modulators work on osteoporosis?

Answer 45

They aim to inhibit bone resorption by inhibiting osteoclasts.

Question 46

Glucocorticoid-induced apoptosis is:

Answer 46

secondary osteoporosis

Question 47

How do glucocorticoids impact osteoporosis?

Answer 47

They work to suppress the immune system, and osteoporosis is a side effect.

Question 48

What effect does menopause have on the RANKL/RANK/OPG system?

Answer 48

decreased estrogen increases RANKL and decreases OPG. Estrogen normally functions to protect bone.