Metabolic Bone Disease Flashcards
What is the definition of osteoporosis?
Bone deterioration with reduced bone mass, and disruption of the microarchitecture of the bone
What is the T score on a DXA scan that indicates osteoporosis?
-2.5
Which bone fracture has the highest mortality rate?
Hip
What is the #1 cause of nursing home admissions in the US?
Hip fracture
What percent of women over 50 years will suffer an osteoporosis related hip fracture?
50%
What are the major issues post hip fracture?
- Increased risk of mortality
- Decreased ability to do ADLs
What is the general amount of treatment (epidemiologically) given post hip fracture?
Low
What is the gold standard in diagnosing osteoporosis?
DXA scan
What is the T and Z score for DXA scans?
T = compared to young adults Z = compared to age-matched adults
True or false: DXA scan results are race and gender matched
True
What is the definition of osteopenia as diagnosed by DXA scan?
-1.0 to -2.5
What is considered normal per DXA scan?
-1.0 to +1.0
True or false: anyone with a fragility fracture, by definition, has a diagnosis of osteoporosis, regardless of T or Z score
True
Who are T scores used for?
Postmenopausal women, and men over 50 yo
Should you ever use a T score in a DXA scan for children?
No
When is a Z score used compared to a T score, in terms of DXA scans?
In patients who are younger than peak bone mass:
- Premenopausal women
- Men less than 50
What is the diagnostic criteria for osteoporosis in terms of Z scores?
less than -2.0
What is the role of smoking and excessive EtOH consumption in the risk for fracture?
Increases the risk
What is the role of body weight in terms of risk for fracture?
Lower weight = higher risk
What is the recommended dose of Vit D3 for patients over 50 years?
800 -1000 IU / d
What are the five recommendations that should be made to patients over 50 years old to reduce the risk for osteoporosis?
- Counsel risk of OP and fractures
- Check for secondary causes
- Vit D3 intake
- Weight bearing exercises
- Avoid smoking and excess EtOH
What is the recommended amount of Ca for patients over the age of 50?
1200 mg/d
When should BMD testing begin in men and women?
Men = over 70 Women = over 65
When is BMD testing indicated for men/women over 50?
Concern for OP based on risks