Ch 12 - Osteoporosis Flashcards
What is a T-score?
of SD away from the mean peak bone mass (PBM) of young adults with the same race and gender
What is normal bone density?
T-score b/w −1 SD and +1 SD
What is Osteopenia?
T-score is between –1 and –2.5, including –2.5
What is Osteoporosis?
T-score is less than –2.5
What is Osteomalacia?
Defective skeletal mineralization of calcium or phosphate of bone osteoid
What is Diffuse idiopathic skeletal hyperostosis (DISH)?
Excessive bone growth characterized by ossification of the ALL of the spine and extra spinal ligaments
What is the Z-score?
of SDs the patient’s bone density is in relation to adults of the same age, gender, and ethnicity
What is peak bone mass?
Highest level of bone mass achieved as a result of normal growth generally occurs between adolescence and age 35, with variation at specific skeletal sites
What is the most common metabolic bone disease?
Osteoporosis
What are non-modifiable risk factors of osteoporosis?
– Caucasian or Asian – Female – Loss of ovarian function/estrogen depletion, testosterone deficiency – Advanced age – Diminished PBM at skeletal maturity – + family history – h/o fracture as adult
What are modifiable risk factors of osteoporosis?
– Malnutrition – Smoking – Excess alcohol – Excess caffeine intake – Inactivity/immobilization – Exercise-induced amenorrhea – Low BMI <20
What is the MCC of osteomalacia?
Vitamin D deficiency
What is Type I osteoporosis?
Postmenopausal – 15-20 years following menopause – Females 50-65 yo – Trabecular > cortical bone loss – Fx in spine, hip, and wrist
What is Type II osteoporosis?
Senile osteoporosis
– >70 yo
– 2:1 female:male ratio – Trabecular ≈ cortical bone loss
– Fx hip, spine, pelvis, humerus
What is the MCC of medication induced osteoporosis?
Corticosteroids inhibits bone formation (↓ osteoblasts); mainly trabecular bone loss
What is the female athlete triad?
Disordered eating
Menstrual disorders
Low BMD
What is the Gold standard for BMD measurement testing?
Dual x-ray absorptiometry (DXA)
What skeletal sites are measured with DXA?
Spine
Hip
Radius
What are proximal femur density measurements useful for?
Predicting hip fractures
What are spine density measurements useful for?
Monitoring response to therapy
What can lead to false readings on DXA?
Spinal osteophytes and aortic calcifications
What % of bone mass loss must occur before demineralization can be detected on x-ray?
30-35%
What are codfish vertebrae?
Increased concavity of endplates if nucleus pulposus has not degenerated
What is the optimal daily intake of Ca?
400-1,500 mg depending on age and estrogen status
What is the optimal daily intake of Vitamin D?
400-800 IU daily
What is the function of calcitonin?
Directly inhibits osteoclastic activity
What can calcitonin be used for?
Derived from salmon
Can dec pain from compression fx
Preserves bone mass
What do bisphosphonates do?
Inc bone mass and red incidence of spinal fx
What are side effects of IV bisphosphonates?
Flu-like symptoms Fever Muscle and joint pain HA Osteonecrosis of jaw Visual disturbances
What are the Most common osteoporotic fractures?
Vertebrae > hip > wrist
What are the Most common vertebral compression osteoporotic fractures?
Lower thoracic, upper lumbar areas
What is the Most common fracture in females > 75 yo?
Wrist fx
