Osteoperosis Flashcards
Which bone type has a faster turnover?
trabecular (thinner)
FASCINATING! How often does the ENTIRE skeleton to turn over?
10 years!
Why do women lose another 10-20% of bone post menopause?
the osteoclasts dig deeper cavities during bone repair
What hormone stimulates the osteoblast to present RANKL?
PTH!
What is the key hormone in BLOCKING osteoclast activity? (which explains post menopausal osteoporosis)
ESTROGEN! it blocks RANKL
What is the chain of events (3) that causes osteoporosis with aging?
- Ca 2+ not absorbed as well w age 2. This increases PTH 3. Stimulates osteoclast activity and overshadows osteoblasts
How does the wrist getting bigger w age help?
Strenght based on radius. Men better then women here
Why does EtOH increase risk of fracture?
EtOH inhibits osteoblast activity
How do glucocorticoids affect bone formation? Ca2+ absorption? Ca loss in urine? Testost and estrogen production?
EVERYTHING BAD!! less bone formation, less ca absorption, more ca loss in urine, less T and E production!
How do we prevent/treat osteoperoisis?
change environment (don’t fall) Vit D & Ca supplement exercise
What do all of these have in common? Calcium, Estrogen, SERMS (selective estrogen receptor modulators), Denoumab, calcitonin, bisphosphonates, and calcitonin?
THEY ALL INHIBIT OSTEOCLAST ACTIVITY!
What two supplements can prevent TOOTH loss!?
Calcium and Vitamin D DAWG!
What did giving estrogen to postmenopausal women do to their fracture frequency?
FREAKING BIG IMPROVEMENTS, there are RISKS tho!
What drugs act as estrogen receptors in bone, but not breast or uterus and have weaker bone effects then estrogen?
SERMs
What are bisphosphonates main action?
increase OsteoClast death! LONG ASS HALFLIFE!
What is defined as non healing of exposed alveolar or palatal bone after 6-8 weeks? (w bisphosphonate usage) Why?
Jaw Osteonecrosis…Bisphos inhibit the process too much! and the jaw has a HIGH turnover rate
Is only the jaw affected with bisphosphonate usage? Are there other ORAL structures affected?
MORE! mucosa, bacteria, dentures cause problems, trauma
Are there risks to Bisphos?
Yes, funky atypical fx
What makes Denosumab too effective? 2 items
turns off bone turnover almost completely so JAW OSETONECROSIS! ALSO RANKL is involved in immune response, so that gets inhibited
Does exercise increase bone density?
ONLY if D1 College Athlete!, but it can STABILIZE bone
What is our COUNTERINTUITIVE osteoporosis fighter?
PTH analogue (hPTH), lets OBs live longer! Actually regrows bone thickness
What are our 2 diagnostic tools to prevent fractures?
DXA scan and FRAX calculator
