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Clin Med I - Endocrine > Osteoporosis > Flashcards

Osteoporosis Flashcards

1
Q

What is the definition of osteoporosis?

A
  • reduction in the strength of bone that leads to increased risk of fractures
  • decreased bone density
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2
Q

Define osteoporotic

A
  • T score of -2.5
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3
Q

Define osteopenic

A
  • postmenopausal women with T score between -1.0 & -2.5
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4
Q

What is the most common bone disease?

A
  • osteoporosis
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5
Q

Why are the morbidity & indirect mortality rates so high with osteoporosis?

A
  • complications of the tx of fxs
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6
Q

Fractures of _____ _____ increase in frequency before age _____ and plateau by age _____ w/only a modest _____ after.

A
  • distal radius
  • 50
  • 60
  • increase
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7
Q

What is the incidence rate for hip fractures after age 70?

A
  • doubles q 5y
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8
Q

What are the complications of osteoporosis?

A

FRACTURES

  • wrist
  • hip
  • vertebral
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9
Q

What are the types of osteoporosis?

A
  • primary

- secondary

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10
Q

What are the types of primary osteoporosis?

A
  • type I

- type II

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11
Q

What is type I primary osteoporosis?

A
  • postmenopausal

- rapid bone loss w/in 6y of menopause, mainly trabecular bone

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12
Q

What is type II primary osteoporosis?

A
  • senile (men & women >75 y/o)
  • slow progression
  • both cortical & trabecular bone
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13
Q

What are the types of secondary osteoporosis?

A
  • sex hormone deficiency
  • hormone excess
  • increased bone resorption/formation ratio
  • multifactorial
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14
Q

What are the types of risk factors for osteoporosis?

A
  • non-modifiable
  • potentially modifiable
  • chronic disease
  • medications
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15
Q

What are the non-modifiable risk factors for osteoporosis?

A
  • postmenopausal
  • white race
  • advanced age
  • personal hx of fx of adult
  • hx of fx in 1st degree relative
  • dementia
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16
Q

What are the potentially modifiable risk factors of osteoporosis?

A
  • low body wt
  • current cigarette smoking
  • ETOH abuse
  • low Ca intake
  • Vit D deficiency
  • inadequate physical activity/immobility
17
Q

What is the MC medication risk factor for osteoporosis?

A
  • glucocorticoids
18
Q

What is the function of bone remodeling?

A
  • repair micro damage w/in skeleton to maintain skeletal strength
  • supply Ca from skeleton to maintain normal serum Ca levels
19
Q

What is bone remodeling regulated by?

A
  • estrogen
  • androgens
  • vit D
  • PTH
  • growth factors
20
Q

What are the S&S of osteoporosis?

A
  • asymptomatic unless pt fxs
  • gradual height loss
  • increased kyphosis of t-spine
  • pain
21
Q

How is osteoporosis diagnosed?

A
  • clinically
    AND
  • DEXA scan
22
Q

How do labs help in the dx of osteoporosis?

A
  • r/o secondary causes
23
Q

What imaging is done for dx of osteoporosis?

A
  • DEXA
24
Q

What do the DEXA results mean?

A
  • T score > -2.5 = osteoporosis

- T score b/t -1.0 & -2.5 = osteopenia

25
Q

What is the non-pharm tx for osteoporosis?

A
  • tx underlying fx
  • reduce underlying modifiable risk factors
  • improve nutrition (Ca & vit D suppl)
  • wt bearing ex.
26
Q

What is the pharm tx for osteoporosis?

A
  • bisphosphonates
  • SERMs (selective estrogen receptor modulators) (not as effective as bisphos)
  • estrogen
  • calcitonin (rarely used)
  • PTH
  • testosterone
27
Q

What is the MOA of bisphosphonates?

A
  • inhibit osteoclast-induced bone resorption

increases bone density

28
Q

What are the side effects of bisphosphonates?

A
  • osteonecrosis of the jaw
  • esophagitis
  • esophageal CA
29
Q

What is the tx length of bisphosphonates & why?

A
  • 5 years

- 1/2 life = 10 years

30
Q

What is the use of SERMs?

A
  • prevention of osteoporosis in postmenopausal women

- reduces vertebral fx risk only

31
Q

What is the use of estrogen for osteoporosis?

A
  • not recommended as 1st line tx

- prevention

32
Q

What is the use of calcitonin for osteoporosis?

A
  • reduces # of new vertebral fx only

- not used in prevention

33
Q

What is the MOA of PTH for osteoporosis?

A
  • stimulates osteoblasts

- increases bone formation

34
Q

What is PTH approved for in tx of osteoporosis?

A
  • both men & women
35
Q

When is T used for osteoporosis tx?

A
  • hypogonadal men to prevent osteoporosis

Clin Med I - Endocrine (6 decks)

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