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58 Cards in this Set
- Front
- Back
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What percentage of women over 85 years of age have osteoporosis?
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50%
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What percentage of women under the age of 65 have osteoporosis?
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19-26%
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What are the three characteristics of osteoporosis?
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Low bone mass
Microarchitectural deterioration of bone tissue leading to bone fragility Susceptibility to fracture |
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What is the name of the curvature of the spine that occurs frequently in osteoporosis?
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Dowager's hump
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A fragility fracture is what?
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A fracture from a mild trauma that would not normally cause a fracture
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At what height are women more susceptible to hip fractures?
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5'7
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At what age is the maximum bone mineral density reached?
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20-30 years old
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What percentage of bone loss happens during early post-menopause?
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2%
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What acid is found in soda that can contribute to osteoporosis?
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Phosphoric acid
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What is trabecular bone?
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Spongy bone in center
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What is cortical bone?
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Outer bone
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What increases in the absence of estrogen?
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Osteoclastic activity
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What are the most important risk factors for osteoporosis?
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Advancing age
Previous fragility fracture |
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Patients taking glucocorticoids are at risk for osteoporosis after how many months of treatment?
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3 months
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What populations of women should be routinely screened with a bone mineral density test?
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Those over 65 years of age
Post-menopausal with risk factor |
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What is the only BMD technique that provides reproducible results?
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DEXA
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What are the diagnostic BMD tests?
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Single-energy X-ray absorpiometry
Quantitative computed tomography Ultrasonography DEXA |
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What are the most concerning fractures to think about in osteoporosis?
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Hip
Spine (also test heel) |
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What is the T-score in a BMD test?
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Number of standard deviations from the young adult mean
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What are T-scores used to establish?
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Severity of bone loss
Diagnosis |
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What is the Z-score?
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Number of standard deviations from age and sex matched control subjects
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What are Z-scores used to establish?
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Possible secondary causes for bone mineral density abnormality
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What labs should be ordered in suspicion of osteoporosis?
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CBC
Ca P LFTs ALP Creatinine TSH Serum protein electrophoresis |
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Creatinine is tested why?
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Screen for kidney disease
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What does FRAX do?
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Calculates 10 year risk of hip or other major osteoporotic fracture for individuals 40-90 years old
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What two things does FRAX require?
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BMD
Clinical risk factor assessment |
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What T-score range indicates low bone mass?
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-1 to -2.5
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What T-score indicates osteoporosis?
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Less than -2.5
(more than 2.5 standard deviations from normal) |
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What T-score and situation indicate severe osteoporosis?
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Less than -2.5 and at least one fragility fracture
(more than 2.5 deviations from normal) |
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At what percentage ranges for 10 year risk of hip fracture is it cost-effective to treat, for both men & women?
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2.5-4.7 percent for women
2.4 - 4.9 percent for men |
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Name 4 bisphosphonate drugs.
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Fosamax
Actonel Boniva Reclast |
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What is the parathryoid hormone drug used to treat osteoporosis?
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Teriparatide (Forteo)
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What is the seletctive-estrogen receptor modulator used to treat osteoporosis?
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Raloxifene HCl (Evista)
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What is the MOA of bisphosphonate drugs?
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Bind to bone apatite and inhibit bone resorption by decreasing the recruitment and activity of osteoclasts
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In what places do the bisphosphonates increase BMD?
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Hip
Spine |
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What drug reduces fracture risk up to 50%?
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Fosamax
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What condition is the use of bisphosphonates contraindicated for?
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Renal insufficiency
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What is the risk of bisphosphonates related to the jaw?
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Osteonecrosis
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What must patients taking bisphosphonates be instructed to do?
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Stand after taking
Take with lots of water (due to risk of esophageal injury) |
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What osteoporosis drugs have an increased risk of a.fib?
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Bisphosphonates
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Teripartatide (Forteo) is what?
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Synthetic PTH administered subQ
Potent stimulator of osteoblastic bone formation |
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What is the most effective treatment available at preventing fractures?
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Teriparatide (Forteo)
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What drug has a potential risk of osteosarcoma?
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Teriparatide (Forteo)
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Teriparatide (Forteo) is reserved for what?
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Treatment failures (bisphosphonates) with less than 2 years of treatment
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What is the most common side effect of Forteo?
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Mild and transient hypercalcemia
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Patients with what two diseases should not be administered Forteo?
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Paget's disease
Osteosarcoma |
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Raloxifene (Evista) is an agonist on what?
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Bone and lipid metabolism
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Raloxifene (Evista) is an antagonist on what?
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Breast and endometrium
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What drug has a 76% reduction in the risk of breast cancer compared to other osteoporosis drugs?
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Raloxifene (Evista)
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What drug reduces the risk of vertebral fracture but not hip fracture?
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Raloxifene (Evista)
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What are the serious risks of Raloxifene (Evista)?
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Thrombosis
Stroke vasomotor symptoms |
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What drug has an uncertain fracture outcome?
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Calcitonin (Miacalcin)
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Estrogen replacement therapy is not commonly used for treatment of osteoporosis because why?
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Risks outweigh benefits
(breast cancer, stroke, thrombotic events, cardio disease) |
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What drug has just ok vetebral fracture data, and no protection for hip/radius?
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Calcitonin (Miacalcin)
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What inflammatory mediators promote osteoporosis?
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IL1
IL6 TNF-alpha Prostaglandin E2 |
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What drug is commonly administered intranasally?
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Calcitonin (Miacalcin)
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What are 4 collagen metabolism disorders that can be secondary causes of osteoporosis?
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Ehlers-Danos syndrome
Marfan syndrome Osteogenesis imperfecta Homocystinuria due to low cystathione |
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What drugs can be a secondary cause of osteoporosis?
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Chronic heparin
Excessive thyroid Dilantin Glucocorticoids Phenobarbital Vitamin D toxicity |
