Osteoporosis

Question 1

What is it?

Answer 1

a metabolic disease that depletes bone mineral density/mass, predisposing individual to fracture

Question 1

population

Answer 1

women 10x more frequently than men

Question 2

Osteoporosis can be features of what two endocrine pathologies?

Answer 2

• hyper-parathyroidism
• Cushing syndrome (hypercortisolism)

Question 3

common sites of fracture

Answer 3

• thoracic and lumbar spine
• femoral neck
• proximal humerus
• proximal tibia
• pelvis
• distal radius

Question 4

types of osteoporosis

Answer 4

• primary/postmenopausal
• senile

Question 5

primary/post menopausal osteoporosis

Answer 5

• directly related to a decrease in estrogen production
• primarily in cancellous bone
• bone becomes more sensitive to parathyroid hormone –> increased reabsorption

Question 6

Senile/Involutional Osteoporosis

Answer 6

• occurs due to a decrease in bone cell activity secondary to genetics or acquired abnormalities
• occurs in cortical and cancellous bone

Question 7

medical management

Answer 7

• calcium
• vitamin D
• estrogen
• calcitonin
• biophosphonates

Question 8

diagnostic tests

Answer 8

• CT scan to assess bone density
• single and dual photon absorptiometry

Question 9

PT goals, outcomes, interventions

Answer 9

• joint/bone protection
• maintain/improve joint mechanics and connective tissue functions
• aerobics
• patient education on dietary changes to improve mineral intake

Question 10

PT management

Answer 10

• weight bearing and resistance eeriness
• balance and fall prevention
• postural retraining, body mechanics, positioning
  *** avoid lumbar forward flexion to extreme end ranges

Question 11

osteoporosis is part of the …

Answer 11

• female athlete triad
• along with amenorrhea and eating disorder
• there is a relationship between menstrual dysfunction and bone mass
• need adequate quantities of estrogen to develop optimal bone peak mass
• risk of bone loss increases with duration of amenorrhea
• risk of stress fracture

Question 12

osteoporosis is a side effect of what medication

Answer 12

• aromatase inhibitors (interferes with production of estrogen in postmenopausal women)
• long term corticosteroids use

Question 13

drug used to prevent osteoporosis

Answer 13

• Premarin
• Conjugated estrogen

Question 14

Side effects of Premarin

Answer 14

• high levels can cause cardiomyopathy/clotting disorders
• GI symptoms
• Cancer - endometrial and breast
• sodium and water retention

Question 15

DEXA results

Answer 15

-1 to +1 is considered normal bone density.
-1 to -2.5 indicates osteopenia (low bone density).
-2.5 or lower is bone density low enough to be categorized as osteoporosis