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Medical Nutrition Therapy > Osteoporosis > Flashcards

Osteoporosis Flashcards

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USMLE® Step 1 flashcards
1
Q

Bones consist of _____, _____, and _______

A

collagen fibers
hydroxyapatite
bone proteins

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2
Q

hydroxyapatite is __________ in combination with ______

A

salts of calcium and phosphate
hydroxyl ions

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3
Q

bone proteins (2) ?

A

osteocalcin
osteopontin

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4
Q

compact bones in the shaft of long bones

A

conical bone

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5
Q

spongey bone found in the knobby ends of long bones, iliac crest, vertebrae, wrists, scapulas, and regions of bone that line the marrow

A

trabecular bone

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6
Q

trabecular bone provides _____ that is exposed to ______ from the ______

increased loss of this bone with _______, it is more responsive to ______

A

surface area
circulating fluids
marrow

aging
estrogen

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7
Q

cell responsible for formation of bone tissue

does this through synthesis of ____ and _____

A

osteoblast

collagen
bone proteins

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8
Q

cell associated with the resorption and removal of bone

this occurs through release of ______ and _____

A

osteoclasts

acids
proteolytic enzymes

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9
Q
  • Where is calcium found?
  • what occurs when calcium intake in inadequate
A

99% of calcium is found in skeleton
1% in extracellular fluid

serum Ca decreases=> parathyroid hormone (PTH) levels increase=> stimulates osteoclast activity to=> pull Ca from the bone to maintain normal serum levels

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10
Q

increases intestinal Ca absorption

A

Calcitriol (active vitamin D)

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11
Q

The skeleton grows until mature ______ is achieved
At this time, bone formation____ bone resorption
Completed in females by ~ ______ and males ~ ______

A

height
>
age 18
age 20

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12
Q

Process where bone is continuously resorbed and reformed through the action of osteoclasts & osteoblasts

A

bone remodeling

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13
Q

bone remodeling is initiated by ________

A

cytokines, interleukin-1

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14
Q

respiration means _____

A

bone loss

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15
Q

Young, healthy adults=> resorption & formation are ________

Older adults=>_________ with increased resorption=> _____

A

balanced, and bone mass is maintained

bone loss

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16
Q

A measurement of the mineral content of bone per unit of bone
Measured by _____________

A

Bone mineral density (BMD)
Bone Densitometry (DEXA)

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17
Q
  • Maximum amount & density of bone accumulated ?
  • Bone _____ continues to accumulate after the length stops.
  • Peak bone mass is reached by ~age ____
  • Greater in_______
A

peak bone mass
mass
30
men

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18
Q

secondary osteoporosis is caused by what diseases and conditions?

A

Hyperparathyroidism
Chronic kidney disease
Chronic malabsorption
Chronic immobilization

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19
Q

secondary osteoporosis is caused by what medications?

A

Corticosteroids
Phenytoin (Dilantin)
Heparin
Methotrexate
Proton pump inhibitors (e.g., Prilosec)

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20
Q

Risk factors for Osteoporosis include…

Age, especially > ____years
______ gender
Hypothalamic amenorrhea
_________ of osteoporosis
_______ depletion from Menopause or Early oophorectomy
Ethnicity: __________
________ depletion

A

60
Female
Family history
Estrogen
Asian or Caucasian
Androgen

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21
Q

Risk Factors for Osteoporosis

________ that adversely affect bone or calcium metabolism
_______ smoking
Lack of _______
______ weight
_______
Inadequate __________ intake
Excessive ______ intake

A

Medications
Cigarette
exercise
Under
Sarcopenia
calcium or vitamin D
alcohol

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22
Q

Lifestyle Modification
- Adequate intake of ________ and ________ to meet the DRIs
- Decrease ______ intake to moderate level
- _______ cessation

  • Increase exercise:
    ______________=>intensive walking, jogging, cycling, walking stairs
    ___________ (e.g., lifting weights, resistance bands, squats, planks, push-ups)
    _____________
A

Ca & Vitamin
alcohol
Smoking

Weight-bearing aerobic activity
Resistance training
Balance exercises

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23
Q

calcium recommendation for
9-18
19-50
51-70
>70

A

1300 mg
1000 mg
1000 mg for males & 1200 mg for females
1200 mg

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24
Q

calcium consumption ????????????

A

???????? idk what she said ab this

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25
Q

Sources high in Calcium

A

dairy products
fortified foods (OJ, soy milk, cereals)
Tofu
Sardines

26
Q

sources that are sources of calcium but are a lil less

A

salmon
turnip and collard greens
soybeans
almonds
legumes
kale
broccoli

27
Q

foods with _____ mg or more of calcium is a good source. However, we can only absorb _____ mg at one time.

A

200 mg
500 mg

28
Q

Factors that enhance Ca Absorption

A

Vitamin D
Lactose

  • spread calcium throughout the day to maximize absorption
29
Q

Factors that decrease Ca Absorption

A

oxalates
Potatoes
excessive insoluble fiber
zinc supplements

30
Q

examples of oxalates

A

spinach
rhubarb
nuts
chocolate
celery
beets

31
Q

examples of phtates

A

legumes
nuts
seeds
whole grains

32
Q

Mean intake for females > 12 yrs _______ meet the DRI

Average intake for:
Age 12-19 yrs: _____ mg/d females; _____ mg/d males
Age > 20 yrs: ____ mg/d females; ____ mg/d males
Age > 70 yrs: ______ mg/d females; _______ mg/d males

A

does not

822
1105

842
1056

771
933

33
Q

Indications that may require calcium supplements

A

osteopenia or osteoporosis
inadequate intake
lactose intolerance
malabsorption
medications that decrease Ca absorption (e.g., corticosteroids)

34
Q

absorption of calcium is optimal when taken ____________ which may include _______.

should choose a supplement that has the _______ sign

A

individual doses off ≤500 mg
vitamin D

United States Pharmacopeia (USP)

35
Q

__________=> contains the most Ca per tablet; ____% elemental calcium

__________=> ____% elemental calcium; most efficient absorption

A

Calcium Carbonate
40%

Calcium Citrate
20%

36
Q

calcium carbonate example

A

Caltrate
Oscal
Viactiv

37
Q

calcium citrate example

A

Citracal

38
Q

Tolerable Upper Intake Level (UL): Calcium

__________ mg (age 19-50 yo)
________ mg (>51 yo)

A

2500
2000

39
Q

excessive calcium intake can result in

________
Deficiency of____ & other minerals

Hypercalcemia can cause:
__________ of soft tissues and blood vessels
_________ and ________ symptoms

A

Kidney stones
iron

calcification
constipation & nausea

40
Q

______________ enhances Ca absorption

A

1,25 dihydroxvitamin D

41
Q

Risk of vitamin D deficiency due to=>

inadequate exposure to _____, inadequate ______ vitamin D, or impaired _________ of vitamin D (___________)

A

sun
dietary
activation (kidney disease)

42
Q

Sources of vitamin D:

A

Ultraviolet rays from the sun
Egg yolks
Fortified milk
Cheese, yogurt
Fatty fish: salmon, tuna, mackerel, sardines, & catfish
Some mushrooms
Fortified soy milk, fortified OJ

43
Q

Older adults often require supplementation

mean reccommendations of vitamin D

A

15 ug

44
Q

Avoid excessive vitamin D supplementation
- can cause _______________

A

hypercalcemia

45
Q

1 mcg = _____ IU

A

40

46
Q

Vitamin K required for the maturation process of __________ which is involved in the __________ process

A

osteocalcin
bone mineralization

47
Q

Individuals at risk for deficiency of vitamin K

  • ____________ may have inadequate consumption of vitamin K
  • ___________ therapy
  • __________
A

Elderly individuals
Antibiotic
Malabsorption

48
Q

Dietary Sources of Vitamin K

A

Green leafy vegetables: spinach, broccoli, collard, mustard, & turnip greens, kale

Green tea

Canola & soybean oil

49
Q

High intake of dietary sodium increases urinary ____ excretion
Avoid foods with > _____ mg Na per serving

A

Ca
300

50
Q

Adequate protein intake is needed for optimal bone health
Recommend _______ for protein
Higher intakes may be beneficial for _________
However, excessive consumption may increase urinary ____ excretion

A

the RDA
older adults
Ca

51
Q

Alcohol is toxic to _______ at high doses

Intake of >___ drinks/d for an extended period is associated with lower _______ and increase risk of ________

Moderate intake is believed to have ________ effect on bone

A

osteoblasts

3
bone density
osteoporosis

no detrimental

52
Q

Relationship with osteoporosis and caffeine ?

Ingestion of caffeine causes short-term increase in_________
Drinking > _____ cups of coffee/day may interfere with _______________

A

has not been clearly established

urinary calcium excretion
3
calcium absorption and cause bone loss

53
Q

Drugs for preventing and treating osteoporosis are usually recommended to be taken along with:
_______________
_______________
Ideally both would be achieved from dietary sources, but if not, supplements should be used

A

Calcium (1000-1200 mg/day)
Vitamin D (800-1000 IU/d)

54
Q

Inhibit osteoclast-mediated bone resorption
FDA-approved for prevention & treatment of osteoporosis in ___________ women
___________ are also approved for use in male osteoporosis

A

bisphosphates

post-menopausal women
Alendronate & risedronate

55
Q

bisphosphate examples

A

Alendronate (Fosamax)
Risedronate (Actonel)
Ibandronate (Boniva)

56
Q

Side effects of Bisphosphates

A

GERD
esophagitis

57
Q

estrogen Agonist Stimulate estrogen receptors in bone tissue which ____________

A

decreases bone reabsorption

58
Q

Estrogen Agonists are FDA approved for both prevention & treatment of osteoporosis in_________women

Little effect on ______ or ______ tissue

A

postmenopausal
breast or uterine

59
Q

Estrogen Agonists Example

A

Raloxifene (Evista)

60
Q

____________ is Low doses of a synthetic, modified parathyroid hormone

A

Teriparatide (Forteo)

61
Q

Teriparatide (Forteo) Increases _______________=> which is a _______ process

FDA-approved for treatment of osteoporosis in _______ women & males at high risk for ___________

A

osteoblastic formation of new bone tissue
anabolic

post-menopausal
fracture

62
Q

Medications for Osteoporosis

A

Estrogen Agonists
- Raloxifene (Evista)

Bisphosphates
- Alendronate (Fosamax)
- Risedronate (Actonel)
- Ibandronate (Boniva)

Teriparatide (Forteo)

Medical Nutrition Therapy (12 decks)

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