Exam 4 - Osteoporosis

Question 1

normal bone mineral density T-score

Answer 1

-1 or greater

Question 2

osteopenia T-scre

Answer 2

between -1 and -2.5

Question 3

osteoporosis T-score

Answer 3

less than or equal to -2.5

Question 4

how is osteoporosis measured

Answer 4

• with a DEXA scan and reported in a T-score

Question 5

osteopenia

Answer 5

thinning of the trabecular matrix of the bone before osteoporosis

Question 6

osteoporosis

Answer 6

• low bone density and structural deterioration of the bone
• usually bones in the hips, vertebrae, and wrists (trabecular bones)

Question 7

osteoporosis characteristics

Answer 7

• low bone mass
• micro-architectural deterioration
• increase in bone fragility
• susceptibility to fracture high

Question 8

major risk factors for osteoporosis

Answer 8

• aging
• female
• caucasian
• fractures as an adult
• family history
• body weight less than 127 lbs
• smoking
• alcohol use
• steroids and immunosuppressive drugs

Question 9

minor risk factors for osteoporosis

Answer 9

• thin, small frame
• lack of weight bearing exercises
• lack of calcium and/or vitamin D
• eating disorders
• gastric bypass surgery
• lack of estrogen/testosterone
• excessive caffeine consumption

Question 10

osteoporosis pathogenesis

Answer 10

• increased bone resorption (osteoclast activity increased)
• decrease bone formations (osteoblast activity decreased)

Question 11

early clinical manifestations of osteoporosis

Answer 11

none

Question 12

late clinical manifestations of osteoporosis

Answer 12

• fractures
• pain
• loss of height
• kyphosis

Question 13

what is one of the main complications of osteoporosis

Answer 13

hip fracture

Question 14

what can hip fractures lead to

Answer 14

• increased risk of mortality

Question 15

what is the most common location for a hip fracture

Answer 15

proximal third of the femur

Question 16

clinical presentation of a hip fracture

Answer 16

• sudden onset of hip pain before or after a fall
• inability to walk
• severe groin pain
• tenderness
• affected leg is externally rotated and shortened

Question 17

what is the primary prevention for osteoporosis

Answer 17

• calcium (diet and supplement)
• vitamin D (diet and supplement)

Question 18

aldendronate

Answer 18

• biphosphase
• reduced fractures by 50%

Question 19

aldendronate MOA

Answer 19

• biphosphate
• binds permanently to surfaces of bones to inhibit osteoclast activity

Question 20

aldendronate adverse effects

Answer 20

• GI common (n/v/d)
• esophageal ulcerations

Question 21

aldendronate teaching points

Answer 21

• take with water
• don’t lie down for 30 minutes after taking
• do not take with food, other drinks, calcium or vitamins for 2 hours (low bioavailability)

Question 22

raloxifene

Answer 22

• selective estrogen receptor modulators
• used as prevention and treatment
• reduces risk of spinal fractures by 50%

Question 23

raloxifene MOA

Answer 23

• mimic estrogen by increasing bone density; inhibits bone resorption

Question 24

raloxifene adverse effects

Answer 24

• hot flashes
• leg cramping

Question 25

does raloxifene have a black box warning

Answer 25

- YES - stroke risk

Question 26

raloxifene teaching points

Answer 26

- must take adequate calcium and vitamin D replacement to work - discontinue at least 72 hours before planned procedures - do not smoke or drink - do not use if pregnant

Question 27

calcitonin-salmon

Answer 27

- treatment only - reduces spinal fractures by 30% - slows down bone loss and increases spinal bone density

Question 28

calcitonin-salmon MOA

Answer 28

inhibits bone removal by osteoclasts