Osteoporosis

Question 1

Osteo?

Answer 1

bone

Question 2

Porosis?

Answer 2

Cavity formation (bone is becoming porous, developing holes)

Question 3

Osteoporosis?

Answer 3

Loss of bone mass (atrophy of bone)

Question 4

Briefly summarize what osteoporosis is.

Answer 4

Loss of bone mass -> increase fragility of bones -> fractures

Question 5

ethology of osteoporosis?

Answer 5

• genetic predisposition (PEAK BONE MASS)
• ageing
• ## loss of estrogen at menopause (estrogen supports bones)

Question 6

how does peak bone mass relate to genetic predisposition?

Answer 6

PBM can be high or low based on genetics (some people may begin with a low bone mass so any loss will result in more rapid development of osteoporosis)

Question 7

What are the 2 major risk factors of osteoporosis?

Answer 7

1. low peak bone mass

2. post menopausal women (loss of estrogen)

Question 8

Around what age does bone loss begin?

Answer 8

30 years old

Question 9

Why are post menopausal women at risk for osteoporosis?

Answer 9

Estrogen production is decreased, estrogen has a protective effect on the bone. It is involved in maintaining the balance between osteoblast and osteoclast activity -> produces mediators to inhibit osteoclast activity and regulate breakdown. Loss of estrogen = decreased osteoclast inhibition

Question 10

Patho of osteoporosis?

Answer 10

Bone remodelling occurs in the skeleton constantly by replacing old matrix with new matrix. Peak bone mass occurs at around 30 years of age. After this time you are only losing bone and you stop building up bone matrix (however, the amount lost depends on your lifestyle). peak bone mass is lost at ~0.7% per year. Imbalance between formation and resorption of bone -> losing bone on an ongoing basis. Micro damage -> bone is internally damaged.

Question 11

What percentage of peak bone mass is lost annually after around 30 yrs of age?

Answer 11

~0.7%

Question 12

If you have 100% peak bone mass at 40 years old, what will you have at 41?

Answer 12

99.3%

Question 13

How much peak bone mass is lost for post-menopausal women?

Answer 13

> 2% / year

Question 14

In osteoporosis, in what part of the bone do most changes occur in?

Answer 14

In the diaphysis and metaphysic which is where most bone growth occurs

Question 15

Manifestations of osteoporosis?

Answer 15

• Usually silent until fracture
• acute, severe pain
  loss of bone:
• spinal distortion
• mandible and dentition
• vertebrae -> change in stature

Question 16

Explain what occurs when there is a loss of bone and spinal distortion occurs.

Answer 16

breathing problem occurs because with osteoporosis, you will see the pt with a hunch because they cannot sit upright. With a hunch, you are applying pressure on the lung and the lungs are not able to expand fully.

Question 17

Why is the mandible and dentition affected in osteoporosis?

Answer 17

Cant chew hard foods -> impacts diet and dietary deficiencies occur

Question 18

diagnostics for osteoporosis?

Answer 18

• bone density scans
• dual- energy X-ray absroptiometry
• Xray

Question 19

What is the principle of bone density scans?

Answer 19

it passes photons of light through the bone (if the bone is less dense, more light will pass through).

Question 20

Which structures are the photons passed through in bone density scans?

Answer 20

• lumbar spine
• radius
• neck of femur

Question 21

Bone is rated on a T-score between 1-2.5. list what the following T scores indicate:

1. 0
2. -1
3. (-1) - (-2)

Answer 21

1. bone is normal
2. low risk of osteoporosis
3. osteopenia -> essentially a precursor to osteoporosis, you will develop it

Question 22

Osteopenia?

Answer 22

decrease in mineral density of bone

Question 23

Goal of Osteoporosis?

Answer 23

• prevention of boneless and early detection

Question 24

Treatment of Osteoporosis?

Answer 24

• adequate calcium and vitamin D consumption
• weight-bearing activity (stimulates osteoblast activity)
• pharmacology: anti-resorptive agents and anabolic agents

Question 25

Purpose of anti-resorptive agents?

Answer 25

inhibits osteoclast activity

Question 26

Purpose of anabolic agents?

Answer 26

enhance osteoblast activity

Question 27

Complication of osteoporosis?

Answer 27

fractures