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Muscoskeletal > Osteoporosis Day 1 > Flashcards

Osteoporosis Day 1 Flashcards

1
Q

What is the big picture of osteoporosis?

A

Fragile bones break

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2
Q

What are the 2 types of bones?

A

Trabecular and Corical

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3
Q

What is trabecular bone?

A

forms the interior structures in honeycombed fashion. It has a large surface area. It is more metabolically active. It has close contact with marrow cells

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4
Q

What is cortical?

A

dense bone that forms the outer shell of the skeleton. Ot is formed in layers and is highly calcified. It is metabollically protective

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5
Q

What are the bone components?

A

collagen, minerals, bone cells

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6
Q

What are the type of bone cells?

A

osteoblasts- bone formation
osteoclasts- breaks bone (respiration)
osteocytes- mature bone cells

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7
Q

What is bone Remodeling?

A

bone mass develops rapidly during childhood and even more rapidly during adolecense. It is the balance of bone breakdown and buildup with a majority replaced every 7-10 years during peak growth

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8
Q

When do you reach peak bone mass?

A

age 20

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9
Q

What is calcium’s role in osteoporosis?

A

taken up by osteoblasts to build bone. It undergoes strict homeostatis.

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10
Q

What does PTH do in osteoporosis?

A

increases blood calcium through reabsorption or distal renal tubular calcium reabsorption. It also stimulates calcitriol production andn RANKL release

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11
Q

What is calcitonin’s role in osteoporosis?

A

Decreases blood calcium through stopping bone resorption and increasing bone formation. it inhibits RANKL release

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12
Q

What is Vitamin D’s role in osteoporosis?

A

It is syntheized in the skin. It is also consumed in the diet. The active form is 1,25 dihydroxyl Vitamin D. Increases serum calcium and phosphorus. It binds to Vitamin D receptor on parathyroid gland and supresses PTH secretion and stimulates RANKL release

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13
Q

What is estrogen’s role in osteroporosis?

A

Suppresses proliferation and differentiation of osteoclases. It increases osteoclast apoptosis but decreases RANKL produciton

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14
Q

What is testosterone’s role in osteoporosis?

A

Suppresses proliferation and differentiation of osteoclases. It increases osteoclast apoptosis but decreases RANKL produciton. It also increases osteoblast proliferaiton and differentiation

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15
Q

When you have low blood calcium what is secreted?

A

PTH

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16
Q

When you have high blood calcium what is secreted?

A

calcitonin

17
Q

What is the process of bone loss?

A

corticol bone gradually decreases yearlt from peak bone mass. It is accelerated in menopause because of decrease in estrediol

18
Q

What are the reasons for primary osteoporosis?

A

postmenopausal and age related

19
Q

when and where in postmenopausal women have osteoporosis?

A

3-4 years after and in vertebral and distal radial fractures

20
Q

Whar are the factors with age related osteoporosis?

A

femals >males
corticol and trabecular bone loss proportional
hips, vertebral and wrist seen

21
Q

What aer the causes of secondary osteoporosis?

A

due to various meds or presence of particular states

can occur ar any age and equal in males and females

22
Q

What medical conditions cause secondary osteoporosis?

A 
endocrine
gastrointestinal 
inflammatory disease
chronic disease
immobility 
genetic
23
Q

What medications cause secondary osteoporosis?

A 
anticonvolsants
glucocorticosteroids
Thiazolidinediones
excess thyroid hormones
excess Vitamin A
24
Q

What causes Childhood Osteoporosis?

A

geneftic defects- cystic fibrosis
endocrine disorders- growth hormone deficiency
nutritional disease- celiac disease
malignancies- leukemia
chonic disease- juvinille RA
conditions associated with disuse- paralysis, muscular dystrophy

25
Q

What causes pre-menoposal osteoporosis?

A

relationship between low BMD and fracture risk not well established
most have identifiable secondary causes
some hace low BMD as a normal varation of BMD
routine bone marrow testing is not cost effective

26
Q

What happens in glucorticoid induced osteoporosis?

A

most common cause of secondary
third most common overall
most that take glucocorticoids chonicly will get
they decrease bone formation through enhanced apoptosis of osteoblasrs, decreasing calcium absorption and increasing urinary calcium excretion

27
Q

What are the 3 components of WHO classification

A

BMD
T score
Z score

28
Q

What is BMD?

A

grams of bone mineral per square centimeter of bone cross section

29
Q

What is T score?

A

compared to mean BMD of sex matched young adults at there peak bone mass

30
Q

What is Z score?

A

compares amount of bone loss with the expected loss for individuals of the same age and sex

31
Q

What are the 3 things that you need to look for in the assessment of OP?

A

risk factors
look for secondary causes
DXA

32
Q

What is DXA?

A

dual energy x ray absorptiometry
should not be given more than every 2 years unless caused by steroids
screening starts at age 65 for women and 70 for men if thery are at high risk

33
Q

What are the modifiable risk factors in OP?

A 
tabacco use
low calcium intake
low Vit D or sun exposure
sedentary life style
low body wt
stress
excessive alcohol 
high caffinee intake
34
Q

What are the non modifiable risk factors in OP?

A 
advanced age
female
caucasian or asian
FH of it
personal history of fragility fracture
lactose intolerence
post menopausal 
premature menopause
35
Q

What are the risk factors for fractures?

A 
low BMD
prior fragility facture
FH
recent fall
cognitive or visual impairment
36
Q

What can the use of tobacco cause?

A 
early menopause
decreasef body wt
enhanced estrogen metabolism 
increased PTH concentration 
decreased Vitamin D concentration
37
Q

Where do the majority of wrist and hip fractures occur form?

A

falls

38
Q

What does FRAX help predict?

A

fracture risk in pts who do not have access to DXA.It gives clinical guidence for treatment decisions. It predicts risk in 10 years. It can be done with or without BMD

Muscoskeletal (9 decks)

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