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Patho II > Osteoporosis > Flashcards

Osteoporosis Flashcards

1
Q

How is osteopenia defined?

A

X ray description of decreased bone density; specifically thinning of the cortex and loss of the trabecule

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2
Q

How is osteoporosis defined?

A

Rapid loss of bone mass prominently in the trabecular bones of post menopausal females, resulting in increased susceptibility to fracture.

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3
Q

What factors influence osteoporosis/bone loss?

A
  1. Age
  2. Consume and absorb less Ca2+
  3. Decrease in Vitamin D
  4. Decrease in physical activity
  5. Female
  6. Estrogen
  7. Family Hx
  8. excessive protein intake
  9. caffeine
  10. Alcoholism
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4
Q

Why are females more prone to bone loss?

A
  1. 8 times more common in females than in males
  2. less bone mass
  3. decreased estrogen after menopause
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5
Q

What is the function of Estrogen?

A
  1. improves Ca+ absorption and decreases Ca+ loss
  2. increased Vit D levels
  3. Stimulates Calcitonin production
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6
Q

What is the treatment of osteoporosis?

A
  1. physical activity and weight bearing exercise
  2. Ca+ supplement
  3. Vitamin D supplement
  4. Estrogen therapy
  5. Floride therapy
  6. Calcitonin therapy
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7
Q

What does estrogen therapy do?

A
  1. inhibits activity of osteoclasts (breaks down bone)
  2. Stimulates osteoblasts (build bone)
  3. Vitamin D supplement
  4. Prevents further bone loss- highest bone density achieved when sued from onset of menopause and continued indefinitely
  5. Reduces fractures 35-60%
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8
Q

What does calcitonin therapy do?

A
  • calcitonin = hormone secreted by the thyroid gland
  • decreases plasma calcium concentration
  • inhibits osteoclasts activity which slows bone resorption
  • may facilitate osteoblasts to produce bone
  • decreases rate of bone loss
  • prescribed for postmenopausal women who can’t/won’t take estrogen
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9
Q

What are the recommended elemental calcium recommendations?

A
  • Children: 800-1200 mg
  • Men and Women (24-64) 1000mg
  • Postmenopausal women with HRT: 1000mg
  • Postmenopausal women with HRT: 1500mg
  • Men and women over 65: 1500mg
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10
Q

How does exercise effect osteoporosis?

A
  • Wolf’s law- skeletal system adapts to forces placed on it
  • disuse osteoporosis?
  • weight bearing to keep calcium in bones
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11
Q

What types of exercise are appropriate for osteoporosis?

A
  • walking
  • swimming
  • weight training
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12
Q

What types of exercises risk vertebral fractures?

A

spinal extension - 16%
spinal flexion - 89%
combined flexion and extension - 53%
no exercise - 67%

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13
Q

What are characteristics of fractures in osteoporosis?

A
  1. more common in females than males

2. incidents increase with age

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14
Q

What are common sites of fractures in osteoporosis?

A
  1. compression fractures– vertebrae
  2. Proximal femur and humerus
  3. Distal radius
  4. Ribs
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15
Q

What are symptoms of fractures in osteoporosis?

A
  1. sudden, sharp pain

2. worse with movement or weight bearing

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16
Q

What are the clinical aspects of fractures in the vertebral column secondary to osteoporosis?

A
  1. decreased spinal movements
  2. paravertebral muscle spasms
  3. subsequent fractures result in kyphosis and decreased lordosis
17
Q

What are the rehab principles of osteoporosis fractures during the acute stage???

A
  1. bed rest, supine
  2. analgesics and muscle relaxants
  3. ice
  4. heat, massage, electrical stim
18
Q

What are the rehab principles of osteoporosis fractures during the subacute stage?

A

patient is able to move side to side without severe discomfort

  1. back brace
  2. increases walking and sitting tolerance
  3. posture and back care training
  4. extension exercises
19
Q

What are the rehab principles of osteoporosis fractures during long term rehab?

A
  1. goal is to prevent further bone loss
  2. home exercise program
  3. resistance training
20
Q

What medications are used to treat osteoporosis?

A
  1. analgesics (pain relievers)
  2. acetaminophen (tylenol, anacin-3, excedrin)
  3. Narcotics (Darvocet, Darvon, Percocet, Percodan, Wygesic)
  4. Muscle relaxants
  5. Alendronate (fosamax)
  6. Raloxifene (Evista)
  7. Risedronate (Actonel)
21
Q

What are examples of muscle relaxants used to treat osteoporosis?

A
  1. Parafon Forte
  2. Robaxin
  3. Soma
22
Q

How does alendronate (fosamax) work?

A
  • binds w/ Calcium phosphate in bone mineral
  • when resorbed by osteoclast results in cell death
  • net result in increased bone density
23
Q

How does Raloxifene (Evista) work?

A
  • serum estrogen receptor modulators
  • binds to estrogen receptors
  • acts as agonist on some estrogen receptors
  • acts as antagonist on other receptor sites
24
Q

How does risedronate (Actonel) work?

A
  • binds with bone to prevent resorption
  • poorly absorbed, cannot be taken w/ food
  • must remain upright 30 min after taking to reduce chance of severe esophageal ulceration
  • incidence of esophageal erosion lower w/ risedronate than Fosamax
25
Q

What is the prognosis of osteoporosis?

A
  • does not alter lifespan itself but may lead to complications which can become life threatening

Patho II (23 decks)

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