Osteoporosis Flashcards

1
Q

What is osteoporosis?

A

Chronic metabolism disease in which bone loss causes decreased bone density and possible fractures

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2
Q

When does bone density begin?

A

Age 30

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3
Q

When does osteoporosis occur?

A

When osteoclastic activity is greater than osteoblastic activity

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4
Q

Age, fam history, thin/lean frame, calcium/vit D deficiency, prolonged steroid use, estrogen deficiency, smoking, alcohol (more than 3/day) excessive calcium/caffeine, increase in phosphate, protein deficiency and immobility are all what?

A

Risk Factors

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5
Q

What helps prevent bone loss?

A

Estrogen

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6
Q

The diagnostic test T-score measures what?

A

Bone mineral density (positive score is less than 2.5)

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7
Q

Which diagnostic test is gold standard for osteoporosis?

A

DEXA Dual X-ray Absorptiometry

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8
Q

What is DEXA?

A

Bone density scan; shows the T score

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9
Q

What is Peripheral quantitative ultrasound (pQUS)?

A

Low cost ultrasound diagnostic test

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10
Q

What are some manifestations?

A

Loss of height, progressive curvature of spine, low back pain, fractures

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11
Q

What are some important nutritional interventions?

A

Adequate protein, Mg, Vit. K, trace minerals and increase in Ca/vit. D intake. Minimal alcohol/caffeine consumption

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12
Q

What are some lifestyle interventions?

A

Exercise (wt. bearing) like swim/walk, strengthen abd/back muscles, smoking cessation, fall prevention and fall risk assessment

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13
Q

What kind of exercises should be avoided to prevent compression of the vertebrae?

A

Running, bowling, horseback riding

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14
Q

What supplementation is commonly given?

A

Calcium w/ or w/o D- Oscal, Citracal

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15
Q

Oscal, Citracal is most readily utilized when?

A

Empty stomach and when @ rest

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16
Q

What should be encouraged when a pt is taking Oscal, Citracal?

A

Adequate fluid intake

17
Q

What is the normal dosing for Oscal, Citracal?

A

PO divided doses of 1-1.5g

18
Q

What are some bisphosphonates used in treatment of osteoporosis?

A

Fosamax, Actonel and Boniva

19
Q

What is the normal dosing for Fosamax?

A

5mg PO QD or 35mg PO weekly (prevent) 10mg PO QD or 70mg PO weekly (treat)

20
Q

What is the normal dosing for Actonel?

A

PO QD weekly or monthly

21
Q

What is the normal dosing for Boniva?

A

PO monthly or IV Q3mon

22
Q

What are some Selective Estrogen Receptor Modulators (SERM) used in treatment of osteoporosis?

A

Evista (oral only)

23
Q

When is Evista contraindicated?

A

When known DVT, pulmonary embolism or retinal vein thrombosis or history of

24
Q

What are some side effects to Evista?

A

Hot flashes, leukopenia

25
Q

Most common side effects of NSAIDs?

A

GI bleed and kidney failure

26
Q

If a pt is to undergo a surgical procedure when should SERM be stopped?

A

72hrs before