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Lifespan > Osteoporosis > Flashcards

Osteoporosis Flashcards

1
Q

Bone fxs

A

Rigid framework for the body

Calcium pool that is interchangeable

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2
Q

Osteoblasts

A

Build bone

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3
Q

Osteoclasts

A

Break down bone

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4
Q

Basic Mechanisms responsible for development of primary osteoporosis

A
  1. You don’t develop appropriate levels while growing

2. Accelerated bone loss after peak bone mass is achieved

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5
Q

Fraction of risk for fracture in postmenopausal women

A

2/3

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6
Q

Main factor affecting peak bone mass

A

Genetic makeup

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7
Q

Rate of bone loss affected by…

A

Nutrition
Behavior
Medications

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8
Q

Non-controllable Risks

A 
Female gender
Small frame
Advanced age
Hormone levels
Genetics
Predisposing medical conditions
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9
Q

Controllable Risks

A 
Cigarette smoking
Excessive alcohol intake
Inactive lifestyle
Excessive caffeine intake
Lack of WB exercise
Poor health
Low weight
Calcium-poor diet
Low Vitamin D levels
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10
Q

In what kind of bone?

A

Cancellous bone

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11
Q

Peak bone mass

A

Mid-20s

Plateaus for ~10 years

Followed by net bone loss of 0.3-0.5% per year

> 60 years old… Osteoblastic activity drops off

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12
Q

Primary

A

Most common in post-menopausal women and older men

Type I
Type II
Ideopathic

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13
Q

Ideopathic

A

Uncommon
Occurs in children and young adults
Normal gonadal function
Both sexes

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14
Q

Type I (Post-menopausal)

A

Age 51-75 - increase osteoclasts
6xs more common in women
Associated with vertebral crush fractures and Colles fractures (distal radius)

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15
Q

Type II (Senile)

A

Older men more common

Normal aging

Gradual decline in # and activity of osteoblasts

Fractures of trabecular and cortical bones: femoral neck, vertebrae, wrist, proximal humerus, tibia, and pelvis

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16
Q

Endocrine disorders

A 
Excess glucocorticoids
Hyperparathyroidism
Hypogonadism
DM
Thyrotoxicosis
17
Q

Prolonged drug use

A 
Steroids
ETOH
Dilantin
Tobacco
Barbiturates
Heparin
18
Q

Other disorders or diseases that contribute

A

Renal disease
Nutritional deficiencies
SCI - decreased WB, mm cxn
MS

19
Q

Osteoporosis signs and symptoms

A

Asymptomatic if uncomplicated

May have pain in mm and bones

Vertebral compressions/crush fractures

Loss of height is common

Multiple compression (mostly anterior) fractures may lead to dorsal kyphosis with an exaggerated cervical lordosis

20
Q

Vertebral fractures

A

Often first sign of osteoporosis

Minimal or no trauma
WB vertebrae (T8 and below)
Pain acute onset
Aggravated by WB
Usually pain does NOT radiate (centralized)
21
Q

Dorsal kyphosis and exaggerated cervical lordosis

A

Dowager’s hump

22
Q

Central DXA/DEXA

A

Standardized test for osteoporosis

Dual energy x-ray absorptiometry

Most commonly used and preferred technique

  • Measured at hip and spine
  • May use radius in forearm if hip or spine cannot be measured
  • Test results reported using t-scores
23
Q

Xray dx

A

Cannot be diagnosed until >30% bone loss

24
Q

US dx

A

Done @ the calcaneus

Not possible to measure hip or spine (too much soft tissue)

25
Q

Quantitative CT (QCT)

A

Much more radiation exposure than DEXA

26
Q

T-score for osteoporosis

A

Normal within 1 SD

Osteopenia within 1-2.5 SD

Osteoporosis beyond 2.5 SD

27
Q

1 SD decrease in BMD…

A

DOUBLING of fracture risk

28
Q

FRAX score

A

WHO Fracture Risk Assessment Tool

Used to guide treatment decisions in people who meet the following three conditions…

  1. Postmenopausal women or men age 50 and older
  2. People with low bone density (osteopenia)
  3. People who have not taken an osteoporosis medicine

Estimates the chance of breaking a hip as well as a combined chance of breaking a hip or other major bones over the next ten years

29
Q

Prevention/management

A

Good nutrition
Hormonal balance
Decreased periods of immobilization
Exercise programs

30
Q

Avoid…

A

FLEXION OF THE SPINE

31
Q

Osteoporosis

A

Most common metabolic bone disease

Mainly of spine (compression) and hips

Lifespan (18 decks)

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