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23 Cards in this Set
- Front
- Back
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Who has the highest risk for osteoporosis? |
white & asian postmenopausal women |
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T/F Osteoporosis & fracture risks are the same |
FALSE NOT the same risk factors |
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Define osteoporosis |
low bone mass (deterioration of bone tissue) disruption of bone architecture compromised bone strength Inc risk of fracture |
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When does peak bone mass (density) occur?
What does it depend on? |
age 30
diet & exercise |
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What is bone mass density (BMD) loss (aka osteoporosis) d/t? |
imbalance btwn bone resorption & formation
d/t accelerated resorption
(dec estrogen--> inc resorption) (inc PTH--> inc formation) |
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In the __________ after menopause (perimenopause) bone loss is up to 2.5% a yr, then it decreases more gradually |
3-5 yrs after menopause (perimenopause) |
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Osteoporosis (low BMD) unmodifiable risk factors: |
age female fracture hx family hx GI dz ESRD |
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Osteoporosis (low BMD) modifiable risk factors: |
low body weight poor nutrition alcohol (<2/day) low Ca2+ intake Hypercortisolism Sex steroid deficiency Cigarette smoking* Sedentary lifestyle (bedrest) Hyperparathyroidism Hyperthyroidism Athletic amenorrhea Medications (glucocorticoids, warfarin, heparin, GnRH agonists, anticonvulsants) |
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Fall unmodifiable risk factors: |
age > 80 Hx of fall multiple co-morbidities cognitive impairment
(*falling is a geriatric syndrome)* |
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Fall modifiable risk factors: |
visual impairment ADL impairment Lower extremity weakness Pain Balance/gait abnormality Depression Use of assistive device Medications (sedative, hypotension, anti-depressants, multiple) |
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what is the most morbid/deadly fracture?
What are the sxs? |
hip (inc mortality 20% in women & 30% men)
sx: pain in hip, groin, low back, or suprapubic forshortening external rotation of one leg |
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Vertebral fractures are the MC fracture & may be silent or present as _________ or loss of height or Dowager's Hump (thoracic kyphosis) |
pleuritic pain (pain w/ each breath)
(*fractures are a good indicator of osteoporosis) |
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Osteoporosis: Prevention |
Adequate Ca2+, Vit D, protein, phosphorus, Mg Strength training (any exercise helps) |
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What is osteomalacia? |
incomplete mineralization of bones following closure of growth plates -looser zones |
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What is renal osteodystrophy? |
osteomalacia + secondary hyperPTH |
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Osteoporosis is dx vis DEXA scan, what are some advantages & disadvantages of this tool? |
measures density (not quality) central more reliable than peripheral standard error of test (try to use same machine) detects changes in trabecular bone best NOT used to predict fracture (does reflect relative risk) |
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Diff btwn T-score & Z-score
Which is more commonly used to classify DEXA measurements? |
T-score: compare current BMD to avg peak BMD of normal young adult of same gender (used for postmenopausal women)
Z-score: compare current BMD to avg BMD of same age, gender, & ethnicity (used for premenopausal, under 50)
*T-score used more |
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What are the DEXA T-score values that classify osteopenia (low bone mass) & osteoporosis? |
osteopenia= -1 to -2.5 SD from young adult peak avg value
osteoporosis= > -2.5 SD |
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Who should be given a DEXA scan (assessed for osteoporosis risk)? |
ALL postmenopausal women Men older than 70 OR anyone w/ osteoporosis risk (fracture, steroid use > 3 mos) |
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osteoporosis: Tx |
Calcium & Vit D Exercise Bisphosphonates Selective estrogen modulators Teriparatide Denosumab NSAIDs for pain |
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What is typically only used to tx vertebral fracture pain in osteoporosis (doesn't fix)? |
(salmon) Calcitonin |
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Why isn't estrogen used as a tx? |
too many assoc risks |
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What is the FRAX tool? |
used clinical & BMD info to predict 10 yr fracture probability
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