CML Anemia Flashcards
Osteoporosis is a _____ in bone mass
reduction
Osteoporosis causes a disruption in skeletal ______
microarchitecture
Fragility of the skeleton in osteoporosis, leads to _______ bone strength & ______ fracture risk
Decreased bone strength & increased fracture risk
Men/women are more likely to develop osteoporosis
women are much more likely to develop osteoporosis
What is responsible for postmenopausal osteoporosis?
estrogen deficiency and age
Bone tissue is lost _____
progressively
What is the lifetime osteoporotic fracture risk for a woman who reaches age 50?
50%
What is the lifetime osteoporotic fracture risk for a man who reaches age 50?
20%
What medications cause secondary osteoporosis?
steroids, antiepileptics
What vitamin deficiency can cause secondary osteoporosis?
Vitamin D deficiency
What are some causes of secondary osteoporosis?
certain medications
Vitamin D deficiency
alcohol
Woman over ___ and men over ___ are at risk for developing osteoporosis
woman over 65 and men over 70
What ethnicities are at increased risk for developing osteoporosis?
White and Asian
What are some risk factors for developing osteoporosis?
Low body weight (<127 lbs or BMI <20) FH of osteoporosis/ fragility fracture Personal history of fragility fracture Long-term glucocorticoid use >2-3 drinks alcohol/day Estrogen deficiency <45 years Testosterone deficiency Low calcium intake Vit D deficiency Sedentary lifestyle Current tobacco use
What is the FRAX algorithm?
Fracture risk assessment tool
What does the FRAX algorithm calculate?
Calculates a patient’s 10 year probability for a fracture
Who is the FRAX algorithm used for?
For postmenopausal women and men age 40-90
The FRAX algorithm is only validated for _____
untreated patients
What test is the gold standard for bone density?
Bone Densitometry (DXA)
What parts of the body are evaluated in a Bone Densitometry (DXA) Scan?
Lumbar spine & hip
Who should get a DXA Scan?
Women ≥65 years old,
men ≥70 years old
Younger but at risk for osteoporosis or osteomalacia
Pathologic fractures
Radiographic evidence for diminished bone density
What determines the interval at which patients should get a DXA Scan?
Interval between scans based on score (T score)
How often does a patient need a DXA Scan with a T score -1.0 to -1.5?
every 5 years
How often does a patient need a DXA Scan with a T score -1.5 to -2.0?
every 3-5 years
How often does a patient need a DXA Scan with a T score
every 1-2 years
What populations is a Z score utilized in?
premenopausal women, younger men, & kids
How does the Z score express bone density?
Expresses bone density as a standard deviation from age-matched, race-matched, and sex-matched means
What T score indicates a normal bone density result?
BMD is within 1 standard deviation (SD) of a young normal adult (T score is greater than −1.0)
What is osteopenia?
low bone density
What T score indicates osteopenia?
BMD is between 1 and 2.5 SD below a young normal adult (T score is −1 to −2.5)
What T score indicates osteoporosis?
BMD is 2.5 SD or more below a young normal adult (T score is less than −2.5)
What T score indicates severe/established osteoporosis?
BMD is 2.5 SD or more below a young adult with 1 or more fragility fractures
What is often the first clinical manifestation of osteoporosis?
fracture, patents are often asymptomatic or have silent symptoms until fracture
What are the SXS of a vertebral fracture?
Height loss or kyphosis
Acute episodes may be associated with pain
Often no preceding trauma or minor trauma (ie: speed bump)
Acute back pain with sudden lifting, coughing, bending
Usually pain localized to midline spine, variable quality
May refer into flank, anterior abdomen, posterior superior iliac spine, radiation into legs rare
May have pain on palpation/percussion of affected vertebrae
What do radiographs in osteoporosis show?
Radiolucency
Cortical thinning
Occult fractures
Bone loss has to be >____to be detected on radiographs
> 30%
What lifestyle modifications should be made in a patient diagnosed with osteoporosis?
Smoking cessation Limit alcohol intake Regular weightbearing and muscle-strengthening exercise Consume at least 1200 mg of calcium/day Adequate calorie intake Take measures in the home to avoid falls Wearing a brace
What are the recommendations for weight-bearing activities in someone who has osteoporosis?
At least 30 mins, 3x/week
