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Kcep 210 final > Osteoporosis > Flashcards

Osteoporosis Flashcards

1
Q

What’s osteoporosis?

A
  • Osteo = bone
  • Porosis = porous
  • Metabolic disease of the bones
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2
Q

What’s does BMD means?

A

Bone Mineral Density

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3
Q

Osteoporosis Diagnosis BMD Measurement - Dual-energy x-ray absorptiometry (DEXA)

A
  • scans entire body
  • measures the risk for fracture in hip, spine, wrist
  • Low level of radiation
  • Less than 5 min
  • 2D images
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4
Q

Osteoporosis Diagnosis BMD Measurement - Quantitative computed tomography (QCT)

A
  • Measures BMD in hip and spine
  • Isolate area
  • Radiation level 10 times higher than DEXA
  • 3D image
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5
Q

Where does osteoporosis starts ?

A

Starts on the inside of a bone

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6
Q

BMD measurement - scores (2 types)

A
  • T-score

- Z-score

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7
Q

BMD measurement - T-score

A

Deviation from the mean bone density of healthy young adult

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8
Q

BMD measurement - Z-score

A

Deviation from the mean bone density of adults of the same age

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9
Q

What is the T-score used by World Health Organization for osteoporosis?

A

-2.5 S.D.

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10
Q

What is the T-score used by World Health Organization for osteopenia ?

A

-1 S.D. to -2,5 S.D.

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11
Q

Calcul of osteopenia for 1000 ± 100 mg/cm2 ?

A

1000 - (100 x 2.5) = 750
1000 - (100 x 1) = 900
BMD of 900 to 750 mg/cm2

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12
Q

What’s a fragility fracture?

A

Any fall from a standing height or less resulting in a fracture

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13
Q

Most common areas of fragility fracture

A
  • hip
  • spine
  • wrist
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14
Q

What’s established osteoporosis?

A

preferred term for people with osteoporosis and one or more fragility fracture

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15
Q

Standard deviation (3 types)

A
  • 1 standard deviation (osteopenia) = 2 times risk of fracture
  • 2 standard deviation = 4 times risk of fracture
  • 3 standard deviation (osteoporosis) = 8 times risk fracture
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16
Q

Standard deviation - Osteopenia

A

-1 standard deviation

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17
Q

Standard deviation - Osteoporosis

A

-3 standard deviation

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18
Q

Z-scores

A
  • use to determine if the bone density loss is secondary to another disease or condition like drug use, alcohol, tobacco, eating disorders, etc
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19
Q

Osteoporosis - Prevalence (incidence)

A
  • 1.4 million in CAN
  • 350 000 in QC (4% of population)
  • 1 out of 4 women over 50 yo
  • 1 out of 8 men over 50 yo
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20
Q

Osteoporosis - why more women than men?

A

because of the decreased of estrogen and smaller bone in women

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21
Q

Osteoporosis - most common fractures

A
  • Vertebra
  • Hip
  • Wrist
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22
Q

Osteoporosis - fractures over 60 yo

A

18% fracture of vertebra

23
Q

Osteoporosis - fractures overs 50 yo

A

15% hip fracture

24
Q

Women between 65-69 are how many times more likely to die within a year after breaking a hip than women of same age who don’t break a hip?

A

3 times more likely

25
Q

trend of women in WHO categories - age 25

A

most women are in the normal categorie

26
Q

trend of women in WHO categories - age 50

A

number of women with osteopenia increase as the women normal decrease

27
Q

trend of women in WHO categories - age 65

A

Same thing as age 50 but with an increase of women with osteoporosis and established osteoporosis

28
Q

trend of women in WHO categories - age 80

A

decrease in women with osteopenia bc osteopenia become osteoporosis

29
Q

Aging effects (2)

A
  • unbalance in bone remodeling process

- Calcium is less efficiently absorbed

30
Q

Aging effects (2)

A
  • unbalance in bone remodeling process

- Calcium is less efficiently absorbed

31
Q

Aging effects - unbalance in bone remodeling process

A
  • Loss of 1% of bone mass each year after 20 yo

- Loss of 2 to 3% of bone mass first 5 year after menopause

32
Q

What positively change the BMD slop?

A
  • Hormones
  • PA
  • Better nutrition
33
Q

Hormones - Roles

A
  • maintain the appropriate level of calcium in the bone

- General response of the skeletal system

34
Q

Role of calcium

A

Calcium controls the activity of the bone cells

35
Q

Hormones - processus

A

CA level - hormones - bone cells - BMD

36
Q

Hormones - lack

A

Bone atrophy

37
Q

Mechanical loading - Roles

A
  • Maintain adequate bone density

- Local response of the skeletal system

38
Q

Mechanical loading - processus

A

Loading - activation of bone cells - BMD

39
Q

Mechanical loading - Absence

A

Bone atrophy

40
Q

Osteoporosis - Risk factors that can’t control with direct effect on bone remodeling (4)

A
  • menopausal
  • prolonged hormonal imbalances
  • removal of ovaries or premature menopause
  • prolonged use or heavy doses of certain meds
41
Q

Osteoporosis - Risk factors that can be control and decreased mechanical loading

A
  • Lack of PA
42
Q

Osteoporosis - Risk factors that can be control and decreased calcium in the bones (4)

A
  • Diet poor in calcium and vitamin D
  • Smoking
  • Caffeine
  • Excessive consumption of alcohol
43
Q

Osteoporosis - classification (3 types)

A
  1. Postmenopausal Osteoporosis (type I)
  2. Senile Osteoporosis (type II)
  3. Secondary Osteoporosis
44
Q

Postmenopausal Osteoporosis (type I)

A
  • Decrease of estrogen = decrease of 10-15% BMD in first 5 yrs
  • Most common
  • Only women
  • Mid sixties
  • Vertebral and hip fractures
45
Q

Senile Osteoporosis (type II)

A
  • Poor absorption of calcium in bone
  • Over 80 yrs
  • 30% are men
  • Forearm, pelvic, hips fractures
46
Q

Secondary Osteoporosis (type III)

A
  • Associated with calcitonin imbalance, malabsorption conditions, alcoholism, smoking and use of meds
  • Can occur in young people
47
Q

Osteoporosis - prevention

A

Hormone remplacement therapy (estrogen)

48
Q

Pros of Hormone remplacement therapy

A
  • Inhibit/ slow down bone resorption

- Decrease effects of menopause

49
Q

Cons of Hormone remplacement therapy

A
  • Increase risk of blood clots, stroke, coronary heart disease
  • Necessary or not?
50
Q

Osteoporosis vs exercise - Goal PA for prevention

A

stress the bone

51
Q

Osteoporosis vs exercise - Types of PA for prevention

A
  • Weight-bearing activities

- Resistance exercises

52
Q

Osteoporosis vs exercise - effect of exercises on the bones

A

Increase pressure on bone = increase bone mass

53
Q

Osteoporosis vs exercise - Consideration for PA for osteopenia/ osteoporosis

A
  • Avoid forward flexion
  • Decrease risk of falling by having adapted equipment
  • Low impact = aerobic dance exercise
  • Resistance training = decrease load and increase repetitions

Kcep 210 final (8 decks)

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