Study Guide 2 Flashcards
What are the types of OP?
- Primary
- Secondary
- Transient OP of the hip
What is primary OP?
- deterioration of bone mass, unassociated with other chronic illnesses or disease
- usu related to aging or menopause
- systemic, bilateral
What is secondary OP?
OP caused by metabolic or endocrine disorders
Transient OP of the hip:
- Onset
- Who gets it
- rare, idiopathic, transitory
- seen most commonly in middle aged men and pregnant women
What is osteomalacia?
Softening of the bones
What causes osteomalacia?
- Vit D deficiency
- lack of exposure to UV rays
Ability to synthesize Vit D and age
Ability to synthesize Vit D through sunlight diminishes after age 40
Osteomalacia: Looser’s transformation zones
Pseudofractures in areas of demineralization
“Rickets” in children usually due to
Malnutrition
What is rickets?
- causes bowing in the long bones
- due to malformation with epiphyseal plates
What is Paget’s disease?
Disordered bone modeling caused by
- genetic factors
- viral infection
What happens to the bones with Paget’s disease?
- produces larger, but weaker bones
- increased fx risk, deformity
Which bones are affected with Paget’s disease?
Specific area, not systemic
- pelvis
- spine
- skull
- tibia
Who is most at risk for getting OP?
- Women
- Over 60
- Caucasian
What pharmacology is used to treat OP?
- Calcium supplements
- Vitamin D
- Bisphosphonates
- Estrogen therapy
OP tx: calcium dosage
~ 1000 units per day
OP tx: vitamin D dose
~ 2000 units/day
OP tx: Bisphosphonates
When are they used and what are two examples?
- this is a 2nd tx option after supplementation is unsuccessful
Fosamax
Aredia
What does Fosamax target?
Osteoclast activity
Which patients will receive estrogen therapy to treat OP? Why?
- postmenopausal women
- oophorectomy
To preserve bone density
Tx for OP pts?
- Exercise (strength, flex, balance)
- AD’s, bracing
- Sunlight
- Surgery
- Diet/supplements
- Smoking - STAHP
- Alcohol consumption - moderation
FRAX =
- Fracture risk assessment (WHO)
- Aimed at preventing fractures
When does OP screening begin for women?
Age 60
DEXA =
Dual energy x-ray absorptiometry
What does a DEXA NOT diagnose with respect to OP?
Doesn’t dx fx’s
How many women over 60 will fall below normal bone mineral density T-score? What does this mean for them?
50%
Candidates for medical tx
Normal DEXA
-1.0 or higher
Osteopenia DEXA
-1.0 » -2.5
OP DEXA
Below -2.5
