Metabolic Disorders

Question 1

Osteoporosis: Definition

Answer 1

Chronic, Progressive disease characterized by:

• low bone mass
• impaired bone quality
• decreased bone strength

Question 2

Osteoporosis: primary

Answer 2

• Post-menopausal women

- Late in men

Question 3

Osteoporosis: secondary

Answer 3

• prolonged other diseases
• corticosteroids
• heparin
• anticonvulsants
• alcoholism
• malnutrition
• malabsorption
• lactose intolerance

Question 4

Osteoporosis: Clinical Manifestations

Answer 4

• loss of height
• postural changes
• back pain
• fractures

Question 5

Osteoporosis: Medications

Answer 5

• Biphosphonates
• Estrogen
• Zoledronic Acid (Zometa)
• EXERCISE

Question 6

Osteoporosis: PT

Answer 6

• Goals - 3-6 mos
• Compliance (important)
• Screening assessment (refer w/ RF)
• Postural assessment
• KNOW side effects of MEDS

Question 7

Osteoporosis: Medical Management

Answer 7

• prevention in first 30 years of life
• calcium rich foods
• vitamin D
• Screening: Females (65) Males (70) BMD

Question 8

Osteomalacia: Definition

Answer 8

• Softening of bone w/o loss of bone matrix

- Known as “RICKETS”

Question 9

Osteomalacia: Etiology (2 main causes)

Answer 9

1 - Insufficient Calcium Absorption
- lack of Ca or resistance to vitamin D
2 - Increased Renal Phosphorus Losses
- Renal Osteodystrophy or Renal Tubular Insufficiency

Question 10

Osteomalacia: Clinical Manifestations

Answer 10

• Initially: diffuse aching, fatigue, anorexia, weight loss
• bone pain peri-articular tender (spine, rib, pelvis, proximal extremities
• Postural deformities (kyphosis, heart pelvis, bowing)
• Muscular weakness

Question 11

Osteomalacia: Medical Management

Answer 11

• Specific to Etiology (dietary, malabsorption, vitamin D)

Question 12

Osteomalacia: PT

Answer 12

• Stabilize or increase bone mass
• prevent falls
• manage symptoms
• educate

Question 13

Paget’s Disease: Definition

Answer 13

• 2nd most common after Osteoporosis
• Excessive Bone resorption and formation w/o structural stability of normal bone
• Deformity
• Fracture
• Arthritis
• Pain

Question 14

Paget’s Disease: Clinical Manifestation

Answer 14

• Insidious
• Progressive Deossification (lumbar spine 55%, Skull 42%, Pelvis 70%, Femur 55%, Tibia 32%)
• Pathological fractures
• Changes in Bone: size / shape / direction
• pain / deformities / arthritis / fractures
• Fatigue / light-headed / general stiffness

Question 15

Paget’s Disease: Cardiovascular

Answer 15

• reduced blood flow to brain
• vasodilation to bones === increased work on heart
• CARDIAC FAILURE

Question 16

Paget’s Disease: Screening

Answer 16

• Alkaline Phosphatase Blood levels

- Bone scans