Lecture 17 Osteoporosis Flashcards
Etiology of OSP: inadequate ____ ____ mass and increased ____ ____
peak bone; bone loss
in OSP, there is greater activity of _____ (resorbs bone) than _____ (replaces bone
oscteoclast, osteoblast
Thinning of _____ and loss of ____ ____ leaves an artitecturally weakened structure with significantly reduced mass –>increased risk of fracture
trabeculae, trabecular plates
Most common fractures seen in osteoporosis; (3)
vertebral, femoral neck, distal radius
OSP affects ____, typically over ___ years of age (due to loss of ____)
women, 50; estrogen
____gonadal states such as menopause in women or androgen____ in men predispose to OSP
hypo; insensitivity
corticosteroid ____ and ____parathyroidism are associated with OSP
excess, hyper
PPI’s may decrease ____ absorption–>OSP
anticoagulants such as ____ are associated
____, an anti-estrogen used for breast cancer is also associated
calcium
heparin
tamoxifen
Prior to fracture, what are the physical findings seen?
typically none
Fractures of the dorsal spine may cause ____
kyphosis
Main screening/diagnostic study?
what does it measure?
DEXA scan; bone density
Other imaging that is recommended
Vertebral x-ray/imaging
What is a marker of bone resportion/turnover?
alkaline phosphatase
in multiple myeloma causing OSP, there will be an elevated ____
ESR
A DEXA T score of what indicates osteopenia:
A DEXA T score of osteoporosis is what?
between -1 and -2.5
less than -2.5
What is a FRAX and what does it do?
WHO Fracture Risk Algorithm;
estimates fracture risk (thus guides therapy)
How to differentiate osteomalacia from OSP?
osteomalacia will have decreased lab values (ie decreased Vit D, phosphate)
What do bisphosphonates do?
inhibit oscteoclast function (induce apoptosis)
Bisphosphonates can irritate the ____ or _____ and should be taken on an empty stomach (want to avoid absorption from other meds/foods)
esophagus, stomach
Estrogen replacement therapy is controversial due to increased risk of ____ and _____
MI, breast cancer (among other things)
Denosumab is a _____ inhibitor
Receptor Activator of Nuclear Factor Kappa B Ligand
aka RANKL
What drug is anabolic (aka builds bone rather than decreases resorption)? It is a _____ hormone.
Potential side effect?
teriparatide (forteo); parathyroid
osteosarcoma
Increasing _____ excercise is key as well as prevention of falls
weight-bearing
