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KCEP 210 > lecture 9: osteoporosis > Flashcards

lecture 9: osteoporosis Flashcards

1
Q

can osteoporosis occur in young adults

A

yes

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2
Q

what is the relationship between osteopororsis and PA

A

stressing bones strengthens them and decrases chance of osteo

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3
Q

the use of what meds can LEAD TO osteoporosis

A

corticosteroisds (drugs used to decrease inflammation)

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4
Q

osteoporosis is what type of disease

A

metabolic disease od the bones

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5
Q

osteo means

A

bone

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6
Q

porosis means

A

pourous =cavities in bone

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7
Q

what does DEXA stand for

A

duel energy xray absorptiometry

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8
Q

what is DEXA used for

A

osteoporosis diagnosis

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9
Q

what does DEXA scan

A

Scans the entire body and measures the risk for fracture in

the hip, spine, and wrist

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10
Q

is the level of radiation high or low in DEXA

A

low

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11
Q

how long does dexa take

A

less than 5 min

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12
Q

DEXA provides what

A

provides 2d images of successive bone laters

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13
Q

what does (QCT) stand for

A

quantitative computed tomography

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14
Q

wha t does QCT measure

A

Measures BMD in the hip and spine and produces a threedimensional
(3-D) image that shows true volume density
QCT. Can isolate an area for testing

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15
Q

the QCT measures BMD in what part of the body

A

hip and spine

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16
Q

the DEXA measures the risk of fracture in what body part

A

hip spine and wristr

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17
Q

is the radiation level higher or lower in dexa or QCT

A

radiation is higher in QCT

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18
Q

the radiation level is BLANK times higher than in dexa

A

10x

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19
Q

what is the The only method capable of distinguishing BMD level between the exterior
cortical bone and the interior trabecular bone

A

quantitative computed tomophraphy

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20
Q

QCT is the only method capable of distringusihing BMD level between what

A

between the exterior

cortical bone and the interior trabecular bone

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21
Q

what is trabecular bone

A

where the bone loss begins

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22
Q

true or false: CT scan can measure BMD inside bones

A

true

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23
Q

true or false DEXA can measure BMD inside bones

A

false

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24
Q

where does osteoporosis begin

A

in the spongy bone

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25
Q

BMD is given as two scores, what are they

A

Tscore

Zscore

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26
Q

what is the Tscore

A

the deviation from the mean bone density of healthy young adults of the same
gender and ethnicity

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27
Q

what is the Z score

A

the deviation from the mean bone density of adults of the same age , gender
and ethnicity

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28
Q

which score is the BMD score compared with the score of healthy young adults

A

tscore

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29
Q

which score is the bmd score compared with the score of adults same age as you

A

z score

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30
Q

which score compares you to health young adults

A

t score

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31
Q

which score compares you with adults the same age as you

A

z score

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32
Q

which score gets rid of the age efect

A

z score

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33
Q

what t score defines osteoporosis

A

a t score of -2.5 sd and below

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34
Q

what t score indicares osteopenia and risk of osteo

A

between -1 and -2.5 sd

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35
Q

if your tscore is between -1.5 sd to -2.5 sd do you have osteopenia or osteoporosis

A

osteopenia

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36
Q

if your tscore is between 2.5 sd and below do you have osteopenia or osteoporosis

A

osteoporosis

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37
Q

KNOW HOW TO CALCULATE THE BMD VALUES (SLIDE 8)

A

.

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38
Q

WHAT IS establish osteoporsis

A

Preferred term for those with

osteoporosis and having one or more fragility fractures

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39
Q

what is a fragility fracture

A

A Fragility Fracture is any fall from a standing heigh or less, that results
in a fracture

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40
Q

true or false: A Fragility Fracture is any fall from jumping

A

false, standing beigh

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41
Q

a body should be able to wistand a fall from what heigh wihotut a fracture

A

standing heigh

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42
Q

what is the only reason you would get a fracture from standing hiegh

A

because of an underlying cause that makes the bones fragile

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43
Q

what are the most common areas of establish osteoporosis

A

wrist, hips and spine

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44
Q

every SD below normal BLANKS the risk for fracture

A

double

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45
Q

-1 standard deviation equals ______ the risk of fracture

A

2x

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46
Q

-2 standard deviation equals ______ the risk of fracture

A

4x

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47
Q

-3 standard deviation equals ______ the risk of fracture

A

8x

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48
Q

if you have -1 SD from mornal you have osteopenia or porosis

A

penia

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49
Q

if you have -3 SD from normal you have osteopenia or porosis

A

osteoporosis

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50
Q

what is used to used to determine whether the loss of bone

density is secondary to another disease or condition

A

z score

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51
Q

the z score is used to determinne what

A

whether the loss of bone

density is secondary to another disease or condition

52
Q

if the z score is lower than expected for age than what does that mean

A

then there
must be something accelerating this loss beyond the
normal process of aging.

53
Q

what are some things that then there

accelerating this bone loss beyond the normal process of aging.

A

drug use (corticosteroids,
anticonvulsants, antirejection drugs etc.), alcohol, tobacco,
eating disorders and others.

54
Q

1 out of how many women over the age of 50 is affected with osteo

A

1/4

55
Q

1/4 women over the age of what arte affected of osteoporosis

A

50

56
Q

1 out of how many men over the age 50 is affected of osteroporis.

A

1/8

57
Q

why is there more women who get osteoporosis instead of men

A

because of menopause (decreaes hormone level)

smaller bones

58
Q

what are the most common fractures because of osteoprosis

A

vertebra
hip
wrist

59
Q

Is the fall due to the femoral neck fracture (A) or is the fracture the result of the fall (B)?

A

the fracture is the result of the fall 80% of the time

60
Q

over 60 years old BLANK are fracture of vertebra

A

18%

61
Q

over 50 years old BLANK are hip fracture

A

15

62
Q

over 60 years old, 18% of fracture are of what

A

vertebra

63
Q

over 50 years old, 15% of fracture are of what

A

hip fracture

64
Q

Women aged 65–69 who break a hip are 3 times more likely to what

A

to die within a year than women of the same age who don’t break a hip

65
Q

Women aged BLANK who break a hip are BLANK more likely to die
within a year than women of the same age who don’t break a hip

A

65-69

3X

66
Q

true or false: when you are youung you have 100% of bone density

A

false

67
Q

as age increases, what is the effect of BMD

A

as age increases, BMD gets lower and lower

68
Q

why does osteopenia istart to decrease near the age of 80

A

because those with osteopenia become osteoporotic

69
Q

true or false: bones are not living tissue

A

false they are

70
Q

what happens to our bones every 3-4 months

A

bone remodelling

71
Q

every how long do we get bone remodlling

A

3-4 months

72
Q

what does bone remodling mean

A

old bone is removed and replaced by new bones

73
Q

what are the bone eroding cells

A

osteoclasts

74
Q

what do osteoclasts do

A

dissolve the mineral and cause small

cavities

75
Q

what are the bone forming cells

A

osteoblasts

76
Q

what do osteroblasts do

A

fill in the cavitsuntil it is restored

77
Q

decalcification =

A

bone resorption

78
Q

calcification =

A

bone formation

79
Q

what is the end product of osteoblasts and clasts

A

new meneralied bones

80
Q

what are the 2 aging effects for osteo

A

1) unbalance in bone remodelling process

2) calcium is less effiencelty absorped

81
Q

after the age of 20, there is a loss of what percentage of total bone mass

A

1%

82
Q

what age is peak BMD

A

20

83
Q

what is the percentage of total bone mass loss each year in women after menopause

A

2-3%

84
Q

How can we positively

change/influence the BMD slope?

A

better nutrition
physical activtity
hormones in post menopausal women

85
Q

bone remodelling is under the control of what 2 things

A

1) hormones

2) mechaninal loading

86
Q

what are the homrones that affect bone remodelling

A

parathyroid hormones, estrogen, testosterone

87
Q

what is the role of hormones in bone remodelling/BMD

A

to maintain the appropriate level of

calcium in the bone

88
Q

what controls the activtity of bone cells

A

calcium

89
Q

lack of hormones leads to =what

A

bone atro[hy

90
Q

what are the general response of the skeletal system

A

hormone release

91
Q

can you rely on only hormones or mechanical loading to maintain BMD

A

no

92
Q

true or false: mecahnial loading is required to maintain adequate bone density

A

true

93
Q

explai nwhy mecahnaial loading is improtant for maintaing BMD

A

contraction/loading =activation of bone cells = increase BMD

94
Q

whta is the local response of the sketal system

A

mechanial system

95
Q

where does degenration occur first

A

spongy bone

96
Q

what happens to bone trabeculae in osteoporosis and what does this lead to

A

The bony trabeculae are thinned out and the mechanical strength of the vertebra
is reduced. This leads to compression fractures and flattening of the vertebra

97
Q

for most fractures damages in the spine they are limited to where and what does that mean

A

lmited to the front of the vertebral column so there is rarely any spinal cord damages

98
Q

where is there usually a fracture in the femur because of osteo

A

at the femoral head

99
Q

which is easier to heal, hip or femur fracture and why

A

femor because it can be replaced by an articfiual head whereas hip you cannot

100
Q

what are the risk factors for osteo that are beyond your control

A 
family hisotru 
female
small bones
menopause
caucasuion/asian
prologngued hormonal imbalances
removal of ovaries or prem menopause (before 45)
prolongued med use
over 50
101
Q

prologunged hormonal imbalances are due to what gland

A

thyroid

102
Q

what 4 factors have a direct effect on the bone remodelling process

A

menopausal
prolongued homronal imbalance
removal or ovaries or prem menopause
prolongued or heavy use of meds

103
Q

if you checked off more than 5 risk facors than you should do what

A 
consider
consulting a health
professional who can guide
your course of prevention
= Physician + Nutritionist +
Kinesiologist
104
Q

what are the risk factors you can control for osteoporosis

A 
lack of PA
diet poor in vit D and calcium
smoking
caffeine
excessive alcohol consumption
105
Q

lack of PA decreases what

A

decreases mechanial loading

106
Q

bad diet, smoking, caffeine, and alcohol decrease what

A

decrease calcium i nthe bones

107
Q

what are the 3 classficiations of osteoporosis

A

1) post menopausal (type 1)
2) senile osteoporosis (type 2)
3) secondary osteo

108
Q

what is the most common type of osteopororis

A

postmenopausal

109
Q

who is the target affected of postmenopausal osteoporir

A

mid sixties (=15 years post menopause)

110
Q

what areas are most likely to get fractured in post menopausal osteipororis

A

vertebral and hip fractures

111
Q

because of the decrease in estrogen after menopause causes what percent decrease in BMD

A

decrease 10-15% BMD in the first 5 years

112
Q

senile osteropororis affects what age bracket

A

over 8- years

113
Q

what percentage of peopel with senilie osteoporosis are men

A

30%

114
Q

what areas are most commonly fractured due to senile osteroporis

A

forearm, pelvis, hip fractures

115
Q

true or false: hip fractures are the most common in senile osteo

A

true

116
Q

true or false: secondary osteoporosis cannot occur in young people

A

false, it can

117
Q

what is secondary osteoporosis assocaitred with

A

Associated with calcitonin imbalance, malabsorption conditions
(e.g., celiac disease, cystic fibrosis, lactose intolerance),
alcoholism, smoking, and the use of certain medications (e.g.,
glucosteroids in arthritis)

118
Q

what is celiac disease and what does it lead to

A

Inability to metabolize peptides in gluten

(wheat, oats, barley). Lead to muscle wasting

119
Q

what is the prevention of osteoproris

A

hormone replacement therapy (estrogen)

120
Q

what are the 2 pros of esttrogen therapy

A

1) Inhibit or slow down bone resorption

  1. decreases Effects of menopause (ex: hot flashes,
    night sweats)
121
Q

what are the 2 cons of estrogen thrapsy for osteoporosis

A

1) ↑ risk of blood clots, stroke and coronary
heart disease
2. Necessary or not?

122
Q

what are the 2 types of PA for prevention of osteoporosis

A

weight bearing activities (walkingm running,dancing, soccer etc)

resistance traning (done with barbells, machines0

123
Q

what is the special consideration for doing RT with osteoporosis

A

high intensities and

few repetitions to increase bone pressure

124
Q

what is the effect of exercise on the bonens

A

increase pressure
on the bone = increase bone
mass
(site specific to the limbs used)

125
Q

what are the 4 special considerations to exrecise for those with osteopenia/porosis

A

Avoid forward flexion of the spine

• Adapt equipment for decrease risk of falling (falls can =
fractures)

  • Aerobic dance exercise = low impact
  • Resistance training = decrase load and icrnease repetitions

KCEP 210 (14 decks)

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