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Osteoporosis & Bone > Osteoporosis > Flashcards

Osteoporosis Flashcards

1
Q

Definition of Osteoporosis
R>F

A

Bone Resorption > Bone Formation

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2
Q

When is osteoporosis most prevalent in menopause

A

5-10 years after

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3
Q

Fall from standing height with fracture

A

Osteoporotic Fracture

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4
Q

Is osteoporosis curable?

A

NO

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5
Q

3 hot spots for fracture bone (HSW)

A

Hip, Spine, Wrist

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6
Q

High risk Factors (5)

A

1) Age >50
2) Females
3) Low Estrogen
4) Glucocorticoid Use
5)Prior osteoporotic fx

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7
Q

Primary cause osteoporosis

A

1) Normal aging
2)postmenopausal

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8
Q

What does having back pain have a increased risk of what fracture

A

Compression fracture

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9
Q

Dowager Hump

A

Kyphosis Thoracic Spine
Height loss
Mobility
Palpate joints and spine (spinous and paraspinous area)

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10
Q

What fracture is increased with Dowager Hump

A

Compression fractures

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11
Q

Exophthalmos, lid lag, goiter, tremor, weight
loss, pretibial myxedema

A

Hyperthyroidism

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12
Q

Dorsal fat, HTN, abdominal striae, central
obesity

A

Cushings

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13
Q

Primary Osteoporosis Labs
Normal vs Deficient

A

NORMAL: Calcium and Phosphorous

Deficient: D Vitamin

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14
Q

Secondary Osteoporosis

A

Serum Ca, PTH, TSH (those on hormone), 24-hour urine calcium, alkaline phosphokinase, testosterone in men

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15
Q
A
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16
Q

Urinary N-Telopeptides, serum C-Telopeptides

A

Bone Resorption Markers

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17
Q
A
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18
Q

Bone Density Test for who

A

Womanaged65orolder
* Managed70orolder
* Break a bone after age 50
* Woman of menopausal age with risk factors
* Postmenopausalwomanunderage65withriskfactors
* Managed50-69withriskfactors
* Adults with condition (RA) or taking a medications associated with bone loss.

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19
Q

Osteoporosis DEXA BMD Criteria (WHO)

A

Bone Mineral Density (BMD)

DEXA T-score < - 2.5

20
Q

NOS T score Spine or Hip

A

T score < -2.5

21
Q

NOS T score Vertebral, Proximal Humerus, Pelvic Fracture

A

T score -1 and -2.5

22
Q

T score

A

normally expected in a healthy young adult of the same sex

23
Q

Z score

A

someone of the same age, sex, weight, and ethnic origin

24
Q

Osteopenia T score

A

-1 to -2.5

25
Q

Osteoporosis T Score

A

> -2.5

26
Q

FRAX Tool

A

Probability having a fracture in next 10 years using BMD

27
Q

Vertebral Fracture Assessment

A

Lateral spine x ray & BMD

Bone scan, CT, MRI, Bone biopsy

28
Q

NOF Vertebral Imaging Recommends

A

Current height compared to peak height during young adulthood

29
Q

Calcium intake how much mg >50 y/o

A

600-700 mg daily

30
Q

Vitamin D intake how much mg >50 y/o

A

800-1000 mg PO daily

31
Q

Bisphosphonate

A

Alendronate (Fosamax)
Risedronate (Actonel)
Zoledronic (Reclast)
Ibandronate (Boniva) –> Women only

32
Q

Monoclonal antibody - dc bone resorption

A

Denosumab (Prolix)

SC q 6 months

33
Q

How to take Bisphosphonates

A

Take on empty stomach 30 minutes before food/drink and don’t eat 30 minutes after

Swallow with full glass of water 6-8 oz

Don’t lie down for 30 minutes

34
Q

Bisphosphonate c/I GFR

A

GFR <30-35

34
Q

Bisphosphonate long term use

A

Osteonecrosis of jaw , Atypical femur fracture
>5 years of treatment or high dose IV bis

35
Q

How long can you take Bisphosphonate Oral and IV (Zolendronic acid)

A

10 years oral

6 years IV Zoledronic acid

36
Q

When can you give calcitonin supplementation

A

> 5 years postmenopausal (nasal and injectable)

37
Q

What increases BMD in early postmenopausal females

A

Miacalcin

38
Q

If you don’t have hysterectomy, what do you need

A

Progestin to protect uterine lining

39
Q

Estrogen Agonist

A

Raloxifene (Evista)
Prevent and tx osteoporosis

40
Q

Bone Anabolic Agents

A

For postmenopause and males high risk
Abaloparatide (Tymlos)
Terparatide (Forteo) –> use for 2 years

41
Q

Bone Anabolic Romosozumab who to avoid in

A

Avoid in MI or CVA in last year. s/e cardiac events

42
Q

What happen when you stop Rank Ligand Inhibitors Denosumab (Prolix)

A

Rapid bone loss occur and result in more fractures SC q 6 months

43
Q

Follow up osteoporosis

A

Annual checkup

Labs and DEXA

44
Q

-height loss,
– new back pain,
– postural change or suspicious finding on chest x-ray,
following the last (or first) vertebral imaging test
– patients being considered for a temporary cessation of
drug therapy to make sure no new vertebral fractures

A

Get vertebral imaging

Osteoporosis & Bone (1 decks)

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