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Skel A > Osteoporosis > Flashcards

Osteoporosis Flashcards

1
Q

Generalized osteoporosis is most prominent in the

A

axial skeleton (VT column, pelvis, ribs, sternum)

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2
Q

Major causes of generalized osteoporosis are

A 
Age
Medication 
    (steroids and heparin)
Endocrine 
     (HPT, hyperthyroidism, cushing's,            acromegaly, pregnancy, diabetes, hypogonadism)
Deficient states 
     (scurvy, malnutrition, calcium deficiency)
Alcoholism
Chronic liver disease
Anemic States
Osteogenesis Perfecta
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3
Q

What is the etiology of generalized osteoporosis?

A

Idiopathic

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4
Q

Is osteoporosis a bone softening disease? why or why not?

A

No it is NOT a bone softening disease
Osteoporosis deals with the decrease in quantity of the bone - but not the quality of the bone. The quality of the bone is normal

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5
Q

Hyperemia stimulates

A

osteoclasts

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6
Q

Regional Osteoporosis is caused by

A

immobilization and dis use - fracture healing

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7
Q

Explain Complex regional pain syndrome - CRPS - which can be related to regional osteoporosis

A

sympathetically mediated pain syndrome e- happens subsequent to trauma - could be suicidal pain

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8
Q

Transient regional osteoporosis means

A

It is self limiting and will usually cure its self after some time

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9
Q

A common example of transient regional osteoporosis is

A

Transient osteoporosis of the hip (TOH)

Regional Migratory osteoporosis

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10
Q

TOH most commonly occurs in

A

middle aged healthy males

rarely seen in women - if so it is during the 3rd trimester or immediate postpartum

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11
Q

Patients with TOH will present with

A

acute disabling pain
functional disability
NO trauma

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12
Q

TOH is

A

paraarticular bone loss around the hip - self limiting - will go away

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13
Q

What differentiates TOH from regional migratory osteoporosis (RMO)

A

RMO jumps from joint to joint

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14
Q

What percentage do we see people with RMO?

A

5- 41%

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15
Q

It is very similar to TOH for example there is no trauma it is idiopathic. T/F

A

True

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16
Q

Is RMO exclusive to one joint?

A

Not exclusive to one joint but the next join too go will be the one closets to the disease

17
Q

Describe osteoporosis

A

general slowing down of osteoblastic activity

18
Q

When does osteoporosis begin for men and women?

A 
Men = 5th - 6th decade aka 40's - 50's 
Women = 4th decade AKA 30's
19
Q

How much bone do men loose after 50 a year?

A

.4%

20
Q

How much bone do women loose after 35 a year?

A

.75%

21
Q

What % increase do women loose more bone post metapause?

A

2 - 3%

22
Q

Symptoms of osteoporosis include

A

spinal pain due to compression fracture, biconcave “fish vertebrae”, hip, wrist, spine

23
Q

List and describe the different Vertebral Body Configurations

A

A. Normal - the horizontal trabecular bone helps with support of the bone
B. Normal with Pencil thin cortices - starting to loose trabecular bone, horizontally
C. Wedge shape owing to anterior loss of height - common in axial load traumas on normal bone
D. Both anterior and posterior bodies collapse - Verebra Planna: bone has been destroyed internally. ( internal destruction - uniform collapse
E. Biconcave: fish vertebrae, owing to gradual endplate depression, the disc pushes the endplate down
F. Angular Endplate depression from acute fracture

24
Q

What bone deformity is classic in osteoporosis

A

Fish vertebrae

25
Q

Explain what a pseudo-hemangiomatour appearance is

A

Over multiple segnemtn levels there is accentuated vertical trabecular patterns of multiple segments - this is a sign of an early manifestation of osteoporosis

26
Q

What is the difference between an pseudo-hemangiomatour and lateral thoracolumbar spine hemangioma

A

Lateral thoracolumbar spine hemangioma has similar appearances but is only on one bone - this is the most common benign tumor of the spine

27
Q

Acute compression fractures of the spine are corrected by what type of surgery

A

percutaneous vertebroplasty - inject bone cement (methyl methacremate) to prevent further fracture

28
Q

Major cause of fracture is osteoporosis - usually a stress fracture that are micor-tramatic - and its findings tends to be bilateral - what are the two types of fractures and explain them.

A

1) fatigue fracture: consistant micro trauma
2) insufficiency fractures: occurs when the elastic strength of the bone is not sufficient o withstand normal physiological stress - type of stress fracture - bone is abnormal it does not have the strength

29
Q

The most common area for insufficiency fracture is

A

The sacrum

“Honda sign”

30
Q

What are osteoporosis risk factors?

A 
ACESS
Alcohol
Corticosteroids
Calcium low
Estrogen low
Smoking
Sedentary lifestyle
31
Q

Osteoporosis is an __________ deficiency not a ______ deficiency

A

Osteoporosis is an osteoblastic deficiency not a ca++ deficiency

32
Q

What is used as the MOST sensitive measure of bone mineral density?

A

DEXA/DXA Scan

33
Q

AKA for Scurvy

A

Barlow Disease

34
Q

Explain scurvy and its association with osteoporosis

A

Subcategory of osteoporosis - it slows down osteoblastic activity because of a LONG TERM deficiency of Vitamin C

35
Q

Scurvy is predominantly seen in

A

infants

36
Q

Vitamin C is essentail in formation in _____, ______, and _______/

A

collagen, osteoid and endothelial linings

37
Q

What are signs of scurvy? What is a hallmark sign of Scurvy?

A 
bleeding gums
cutaneous petechiae
hematuria (kidney bleeding)
Fragile capillaires
-hallmark is spontaneous hemorrhage due to capillary fragility - sub periosteal = bone pain because it lifts up the periosteum 
decreased osteoblastic function
38
Q

Hypovitaminosis C/Scurvy in Pediatrics SIGNS

A

White line of Frankel = dense zone of provionsal mineralization - appears brighter
Limburger’s ring = dense cortical margin of epiphysis with radiolucent center (brighter)
Corner (angle) sign = irregular metaphysical margin
Pelken’s sign = bony protuberance at margin of zone of provisional mineralization
Trummerfeld/scorbutic zone = radiolucent band directly beneath zone of provionsal mineralization

39
Q

Reflex Sympathetic Dystrophy Syndrome (RSDS)

A

aka for CRPS

Skel A (5 decks)

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