Osteoporosis Flashcards
3 types of osteoporosis
- primary
- secondary
- transient osteporosis of the hip
What is primary osteoporosis?
deterioration of bone mass, unassociated with other chronic illnesses or diseases
-Usually related to aging, menopause
What is secondary osteoporosis?
caused by various endocrine or metabolic disorders (G&S, Table 11-13, p. 439)
What is transient osteoporosis of the hip?
rare, idiopathic, transitory
- middle-aged men and pregnant women
Pharmacology for Treatment of
Osteopenia/Osteoporosis (4)
- Calcium supplements, ~ 1000 units/day
- Vitamin D ~ 2000 units/day
- Biophosphonates-(work by osteoblast activity, interferes/changes bonebuilding)- osteoporosis, Paget’s disease, others
- Fosamax, Aredia, etc.
- Estrogen therapy for post menopausal women and ovariectomy (also called oophorectomy) to preserve bone density
Methods for screening for osteoporosis
- FRAX (Fracture Risk Assessment, WHO)
- DEXA scan (Dual Energy X-ray Absorptiometry)
At what age do we start screening women for osteporosis?
60
•50% of women will fall below normal bone mineral density T-score and be candidates for medical treatment
Points about osteoporosis, age, and changes in bone
- Age related bone remodeling and body type
- Breakdown is greater than build-up
- Bone growth and storage into the 20’s - diet and exercise puts bone in the bank!
- Systemic and bilateral
- Fracture and deformity risk systemically
Vertebral fractures and osteoporosis (pic)
What is Osteomalacia?
- Softening of bones due to vitamin D deficiency, lack of exposure to UV rays
- (note: ability to synthesis vitamin D through sunlight diminishes after age 40)
- Looser’s transformation zones – pseudofractures in areas of demineralization
- Called “rickets” in children, usually malnutrition – causes bowing of long bones due to malformation with epiphyseal plates
- May have bowed legs
What is Paget’s disease? (3)
- Genetic factors or viral infection that produces disordered bone modeling (not systemic)
- Produces larger bone when it heals, but is weaker
- Fracture risk, deformity
- Specific area, not systemic
- Pelvis, spine, skull, tibia (unilateral), etc.
List of things to think about for treatment of people with osteoporosis or Paget’s disease (7)
- Exercise–Stretching, strengthening, balance, weight bearing activity (30 min a day)
- Assistive device/bracing
- Sunlight- for vitamin D (ability to absorb decreases with age)
- Surgery- depending on degree of deformity
- Diet/Supplements
- Smoking- quit
- Alcohol consumption- moderation
Norms for T-scores (from Dexa scan)
- -1 and above
- Your bone density is considered normal
- -1 and -2.5
- Your score is a sign of osteopenia, a condition in which bone density is below normal and may lead to osteoporosis.
- -2.5 and below
- Your bone density indicates you likely have osteoporosis.
Points about treatment of vertebral fractures
- It’s a mega bummer
- Typically T-spine
- Putting people into a brace which puts them into extension while Fx heals
