trigger - Osteoporosis Flashcards
These cells recylce calcium back into the blood stream
Osteoclasts
PTH stimulates what
osteoclasts to breakdown bone and increase blood clacium levels!
If you have high blood calcium levels, what happens in the body
thyroid releases calcitonin to seep calcium from blood and build it into teh bone
stimulates osteoblasts
Osteoporosis is loss of …… AND ……
bone mineral AND matrix!
what are the 3 reasons adolescents may have osteoporosis
- disease
- malnutrition
- inactive lifestyle
inhibits osteoclasts
estrogen
I made a dumb pnemonic for meds that cause osteoporosis so 5 this if you dont want it
its: Very CALM DASH
Valproic acid
cyclosporine
antacids
lithium
MTX
Depo-provera
aromatase inhibitors
steroids
heparin
what are the 3 pathological fractures
- compression fx of vertebre
- hip fracture
- distal radius (Colle’s)
T-score of -1.98 would be considered…..
osteopenia!!
()-scores are compatred to 30 year olds whereas ()-scores are compared to peer of equal age/gender
what would a “bad” score for either of these suggest
T-score = 30. Bad = osteoporosis/osteopenia
Z-score = peer of equal age/gender. Bad = secondary cause for osteoporosis
NOTE!!! only the T score is used for dx.
10 year likelihood of osteoporotic or hip fx is called
FRAX score
what can you technically consider an osteoporosis diagnosis
avoid this calcium replacement if the pt takes a PPI. it also must be taken w food
calcium carbonate
calcium citrate = no food and okay w ppi
oversupplementation of calcium can potentially lead to…
cardiac arrhythmias
what do bisphosphonates do in relation to osteoporosis/osteopenia treatment
cause apoptosis of osteoclasts
This medication has a SE of osteonecrosis of the jaw
bisphosphonates
If a pt has a CKD CI and therefore cannot use bisphosphonates, what might you give them instead
denusumab
what would you give a patient who has osteoporosis/osteopenia + frax w a hx of Roux-en-Y gastric bypass surgery
annual IV zoledronic acid!
given when pt has CI to bisphosphonates that isnt CKD
if CKD CI then use denosumab
if your patient has osteoporosis/osteopenia + FRAX and also has a high risk of breast cancer, what can you treat them with
SERMs (raloxifene)
does increase risk of thomboembolic events though
A patient is undergoing a drug holiday from their bisphosphonate. What medication could you give them if needed during this time to treat their osteoporosis
romosozumab (PTH/PTH protein analog)
disease associated with affecting collagen 1 in connective tissue
osteogenesis imperfecta
which type of osteogenesis imperfecta is lethal
type 2
which Osteogenesis imperfecta presents with moderate fragility, bluie sclera and <10% hearing loss
Type IV
which osteogenesis imperfecta presents with premature accelerated osteopososis
height normal.
Type 1
which type of osteogenesis imperfecta results in scoliosis, short stature, triangular face, frequent fx, and hearing difficulties
Type 3
