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7262 MS Block 2 > Osteoporosis Pathophys Atanda > Flashcards

Osteoporosis Pathophys Atanda Flashcards

1
Q

What two groups have the highest osteoporosis fragility fracture rates?

A

caucasian

hispanic

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2
Q

Calcium homeostasis is maintained by what two things?

A 
vitamin D 
parathyroid hormone (PTH)
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3
Q

Calcium absorption is 30-35% under normal conditions and decreases to __ to __ with low vitamin D levels

A

10, 15

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4
Q

Vitamin D levels depend on what 3 things?

A

skin conversion
dietary/supplemental intake
PTH

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5
Q

What is the most abundant source of vitamin D?

A

cholecalciferol (D3)

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6
Q

Where does conversion from cholecalciferol and ergocalciferol to 25(OH) vitamin D (calcidiol) occur?

A

liver

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7
Q

Where does conversion from active vitamin d (calcitriol) occur?

A

kidneys

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8
Q

What effect does high calcium levels in the blood have on parathyroid?

A

signals parathyroid to stop making PTH

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9
Q

What is released when calcium levels in the blood are low?

A

PTH

pulls calcium from stomach, then renal system, then bones if not sufficient

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10
Q

Estrogen:

Accelerated bone loss begins during perimmenopause and continues up to __ years post menopause

A

8

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11
Q

What type of bone is most susceptible to estrogen deficiency?

A

trabecular

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12
Q

The estimated bone loss bc of estrogen deficiency is __ % per year

A

2

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13
Q

How do PPIs cause bone loss?

A

calcium malabsorption due to acid suppression

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14
Q

Glucocorticoids __ bone resorption and __ bone formation

A

increase, decrease

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15
Q

Which type of diuretics can cause osteoporosis?

A

loop

furosemide

thiazides can cause HYPERcalcemia

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16
Q

Which is not associated with increased risk of osteoporosis?

a. thiazides
b. loop diuretics
c. PPI
d. SSRI
e. thiazolidinediones

A

a. thiazides

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17
Q

Type I osteoporosis lasts about __ years

A

10

Primary osteoporosis:

  • type I
  • type II
18
Q

Which type of osteoporosis occurs equally in men and women of ANY age?

A

type III

secondary osteoporosis

19
Q

Which type of osteoporosis is postmenopausal?

A

type I

20
Q

Which type of osteoporosis is type II?

A

age-related/senile

primary osteoporosis:

  • type I
  • type II
21
Q

Which type of osteoporosis occurs in men and women over 75 years old?

A

type II

primary osteoporosis:

  • type I
  • type II
22
Q

Which type of osteoporosis is associated with vertebral and distal forearm fractures?

A

type I (postmenopausal)

primary osteoporosis:

  • type I
  • type II
23
Q

Which type of osteoporosis is associated with vertebral, hip, and wrist fractures?

A

type II (age-related or senile)

primary osteoporosis:

  • type I
  • type II
24
Q

Which type of osteoporosis is associated with drug related causes?

A

type III

ex. glucocorticoids

secondary osteoporosis

25
Q

Which type of osteoporosis is associated with impaired osteoblast function and increased osteoclast activity?

A

type III (occurs equally in men and women of any age)

secondary osteoporosis

26
Q

Which type of fractures have the greatest increase in morbidity and mortality?

A

hip

27
Q

What T-score is indicative of osteoporosis?

A
  • 2.5 and below
28
Q

What test is the gold standard for measuring bone mineral density?

A

X-ray absorptiometry (DXA)

T score 2.5 and below

29
Q

Loss of height of > __ inches or historic height loss of > __ inches is indicative of osteoporosis

A

0.8, 1.5

  1. 8 inches = 2cm
  2. 5 inches = 4cm
30
Q

2 tools for osteoporosis risk factor assessment?

A

FRAX

Garvan

31
Q

Women __ years and older should get DXA screening

A

65

increased risk for osteoporosis

32
Q

Postmenopausal women > __ years should get DXA screening

A

50

increased risk for osteoporosis

33
Q

Should men get DXA screening?

A

insufficient data to recommend screening

34
Q

Which assessment tool uses 11 risk factors and BMD at the femoral neck?

A

FRAX

fracture risk assessment tool

35
Q

The FRAX tool assesses what?

A

major osteoporotic (spine, forearm, hip, shoulder) and hip fracture in next 10 years

36
Q

FRAX assessment is validated in postmenopausal women or men __ and older

A

50

37
Q

FRAX assessment is validated for use in what populations?

A
  • postmenopausal women or men 50 and older
  • people with low bone density (osteopenia)
  • people who have not taken osteoporosis meds
38
Q

__ is low BMD or “pre-osteoporosis”

A

osteopenia

39
Q

What DEXA T-score indicates osteopenia?

A

-1 to -2.5

40
Q

What DEXA T-score indicates osteoporosis?

A

-2.5 and below

41
Q

Which DEXA score uses comparison to young adult reference?

A

T-score

42
Q

Which DEXA score uses comparison to age matched reference?

A

Zscore

7262 MS Block 2 (10 decks)

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