More Osteoporosis stuff Flashcards
What are the diagnosis ranges for T scores?
> -1 = normal bone density
-1 -2.4 = Osteopenia
<-2.5 + one or more fractures = Severe osteoporosis
What are the two types of bones? Which one is more involved in bone resorption?
Cortical
Trabecular (more involved)
Explain the steps of bone formation
1) Initiation of bone remodeling
2) Differentiation and activation of osteoclasts
- Rank ligands causes precursors to convert to osteoclasts
3) Osteoclast bone resorption (can reverse for osteoblast activity)
- Natural RANK ligand inhibitor (OPG) binds to RANKL to stop resorption
4) Bone formation by osteoclasts
Why would having low amounts of estrogen lead to osteoporosis?
Estrogen increases osteoclast apoptosis and increase production of OPG
Name some nonmodifiable risk factors for osteoporosis
Female
Caucasian, Asian
Advanced age
Thin, small body frame
Estrogen deficiency at early age (<45 YO)
Postmenopausal, estrogen deficiency
What is the gold standard in terms of BMD testing?
DXA
What are some signs and symptoms of osteoporosis other than DXA T scores?
Decreased breath sounds due to posture Decreased movement Severe back pain Loss of height Spinal deformities Stooped posture
Why are PPIs a concern in osteoporosis-risk patients
PPIs make the stomach acid more basic and hinders the absorption of Ca++ unless calcium citrate is taken
What is the DOC for calcium supplementation? Why?
Calcium carbonate because it contains the most elemental calcium
Which calcium supplement can be taken with a PPI or with any acidity change in the stomach?
Calcium citrate
What is the NIH recommendation of vitamin D supplementation? (HINT: 2 of them)
< 70 years 600 IU
>70 years 800 IU
What is the other name for vitamin D3? D2?
D3 = cholecalciferol D2 = ergocalciferol
