Osteoporosis Flashcards
Is just the density of the bone affected in osteoporosis?
No. Quality is decreased as well.
Is osteoporosis often silent?
Yep.
How many US men and women will have an osteoporosis-related fracture in their lifetimes?
1 in 2 women.
1 in 5 men.
What factor contributing to bone strength do we measure?
Density, with DXA.
Two main causes of low bone density late in life?
Low peak bone mass - never built it up.
Excess loss.
4 lifestyle factors that contribute to osteoporosis?
Low calcium intake
Vitamin D deficiency
EtOH intake > 3 drinks/day
Low BMI
2 significant genetic risk factors for osteoporosis?
Family Hx of hip fractures.
Idiopathic Hypercalciuria
3 endocrine disorders that contribute to osteoporosis?
Hypothalamic Amenorrhea
Hyperparathyroidism
Thyrotoxicosis
(there are many others - Cushing’s, DM, hyperprolactinemia, etc.)
Main GI disease to screen for related to osteoporosis?
Celiac
Most important (according to highlighting) hematologic disorder related to osteoporosis?
Multiple myeloma.
Why does end stage renal disease (ESRD) contribute to osteoporosis?
Impaired Vitamin D activation.
Does rheumatoid arthritis contribute to osteoporosis?
Yeah.
5 medications that cause osteoporosis?
Anticonvulsants PPIs Aromatase inhibitors Depo-medroxyprogesterone Glucocorticoids
Osteoporosis diagnosis is only given to what demographic?
Post-menopausal women.
Men over age 50.
What part of the DXA scan results matters for osteoporosis diagnosis? What is the cut-off for diagnosis of osteoporosis?
T-score
Cut-off = -2.5
What is the T-score in DXA scans?
Number of standard deviations away from average bone density of young adults.
What is the Z-score in DXA scans?
of standard deviations away from average bone density of age-matched controls.
What areas are usually scanned in DXA?
Lumbar spine, total hip, femoral neck (and sometimes forearm).
What T-scores for DXA are in the normal range?
-1 to 1
What’s a T-score of -1 to -2.5 called?
Osteopenia.
What gives a osteoporosis diagnosis a designation as “severe”?
Having had a fracture.
How can you diagnose osteoporosis without a DXA scan?
History of “low-trauma” fracture.
Do the majority of fractures happen in people with osteoporosis?
No. (hip fractures in women do, though)
…is this just because there are more people with osteopenia and normal bone density???
7 risk factors in the Fracture Risk Assessment Tool (FRAX)?
Previous fracture Age Family Hx of osteoporotic fracture Smoking Low BMI Alcohol Glucocorticoids
