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Interventional Spine > Osteoporosis & The Patient > Flashcards

Osteoporosis & The Patient Flashcards

0
Q

List three major risk factors for osteoporosis.

A
  1. Low calcium diet
  2. Thin and/or small frame
    Race (white or Asian)
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1
Q

What is osteoporosis?

A

A skeletal disorder characterized by compromised bone strength.

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2
Q

Which of the following is info provided by the physical examination and patient history

A. Presence of chronic conditions, behaviors, and level of physical fitness

B. Fracture history

C. Dowagers hump

D. All of the above

A

D. All of the above

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3
Q

T or F: DEXA is one of the most widely used techniques for measuring bone density

A

True

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4
Q

T or F: DEXA can measure bone density in the spine, arm, leg, and total body

A

True

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5
Q

T or F: osteoporosis is diagnosed when the T score is more than 2.5 standard deviations below the sex-adjusted mean for normal young adults at peak bone mass OR the patient has a fragility fracture

A

True

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6
Q

T or F: it is currently not possible to reverse osteoporosis

A

True

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7
Q

T or F: ultimately, half of all women and men will have a hip fracture

A

True

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8
Q

T or F: osteopenia is not as clinically severe as osteoporosis

A

False

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9
Q

T or F: typically osteoporotic fractures include fractures of the vertebra, forearm, wrist, and hip

A

True

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10
Q

List three nonpharmacologic treatments that appear effective on preventing the progression of osteoporosis

A
  1. Weight bearing exercise
  2. Adequate calcium intake
  3. Adequate vitamin D intake
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11
Q

Which of the following is part of the downward spiral?

A. The VCF CAN PUT STRESS ON THE SPINE, which can predispose towards more fractures, in turn exacerbate the initial fracture

B. Increased flexibility

C. Blood loss

A

A

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12
Q

Which of the following are types of VCFs?

A. Crush fractures
B. Wedge fractures
C. Both a and b

A

C

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13
Q

Which of the following is true?

A. Most VCFs come to clinical attention
B. Women have twice as many VCFs as men
C. Non- whites are at higher risk for VCFs than whites

A

B

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14
Q

Which of the following describes the risk factors for VCFs?

A. Common primarily in very active ppl
B. Frequently the result of falls
C. Similar to the risk factors for osteoporosis

A

C

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15
Q

VCFs impact Pxs, their families, and society through:

A
  1. Hospitalization
  2. Cost of illness
  3. Quality of life
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16
Q

True or false the financial cost of VCFs includes medical care, loss of productivity, caregiver time and lost activities of daily living

A

T

17
Q

True or false: VCFs have little impact on the patient’s quality of life

A

False

18
Q

Which of the following describes the physical consequences of VCFs:
a. Back pain, spinal deformity, and decreased lung capacity
B. Increased appetite
C. Forgetfulness

A

A

19
Q

T or F: The purpose of the vertebral compression fracture treatment is to halt bone resorption, prevent subsequent fractures, lessen pain, and reestablish vertebral height

A

T

20
Q

T or F: pharmacological treatments for VCFs are distinct from treatments used for osteoporosis

A

False. Pharmacological treatments of the VCFs are similar to those for osteoporosis

21
Q

Nonpharmacological options for VCFs include

A 
A. Physical therapy 
B. Ice massage 
c. Braces 
D. Vertebroplasty 
E. kyphoplasty
22
Q

Describe the effect of HRT on osteoporosis

A

HRT can prevent bone loss but is unable to restore bone mass

23
Q

Describe the effect of HRT On post menopausal symptoms

A

HRT IS EFFECTIVE AT RELIEVING POST MENOPAUSAL SYMPTOMS SUCH AS HOT FLASHES AND VAGINAL DRYNESS

24
Q

Describe the effect of HRT on Osteoporotic fractures

A

HRT DECREASES THE RISK OF OSTEOPOROTIC FRACTURES

25
Q

Describe the effect of HRT on coronary heart disease

A

HRT causes a 22% increase in total cardiovascular disease and a 29% increase in the risk of myocardial infarction and coronary disease

26
Q

List the three most popular types of HRT

A
  1. OrthoPrefest
  2. CombiPatch
  3. Prempro
27
Q

How do SERMs differ from estrogen?

A

SERMs, such as raloxifene, mimic the effects of estrogen in one or more target tissues while simultaneously blocking it’s effects in other tissues

28
Q

What is the advantage of raloxifene?

A

Raloxifene is effective at preventing post menopausal osteoporosis without causing endometrial proliferation or increasing the risk of breast cancer. It also provides the lipid profile.

29
Q

What are the disadvantages of raloxifene?

A

Raloxifene has been shown to cause an increase in venous thrombosis as well as hot flashes and leg cramps

30
Q

List the SERMs that are currently available for the treatment of osteoporosis

A

Raloxifene

31
Q

How do biophosphonates prevent bone resorption?

A

Biophosphonates bind permanently to mineralized bone surfaces and inhibit osteoclastic activity during bone resorption

32
Q

What are the advantages of bisphosphonates?

A

Bisphosphonates are effective in the prevention and treatment of osteoporosis. Alendronate is the only medication approved for the treatment of osteoporosis in men

33
Q

What are the disadvantages of bisphosphonates?

A

They can cause abdominal and musculoskeletal pain, nausea, heartburn, and irritation to the esophagus. In addition, the must be taken on an empty stomach

34
Q

List the currently available bisphosphonates

A

Alendronate, and ibandronate, risedronate, and zoledronic

Remember AIRZ AND DRONATE

35
Q

How does calcitonin prevent bone resorption?

A

Calcitonin increases the levels of calcium and potassium in the bones and lowers the levels of calcium in the blood

36
Q

What are the advantages of calcitonin?

A

It reduces the risk of new VCFs and occasionally able to relieve pain from spinal fractures

37
Q

What are the disadvantages of calcitonin?

A

There are minimal risks associated with calcitonin compared with other pharmacological treatments of osteoporosis. The nasal form can upset stomach, diarrhea, and flushing. Calcitonin appears to be the least effective of the osteoporosis medications available

38
Q

How does forteo stimulate bone growth?

A

Forteo stimulates osteoblasts to build new bone and improve bone density

39
Q

What are the advantages of forteo

A

Forteo can actually build new bone. This is in contrast to other treatments for osteoporosis, which rely entirely in the anti-resorptive mechanism of action

40
Q

What are the disadvantages of forteo?

A

There are some questions as to whether or not forteo will increase the incidence of bone cancer in humans. This concern has led to a recommendation that patients be prescribed forteo for no more than a 2 year duration

41
Q

Osteoporosis definition

A

Bone condition in which bone mass is reduced, but normally mineralized

Interventional Spine (5 decks)

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