Osteo

Question 1

Recommended calcium intake recommended for adolescents and young adults 11-24

Answer 1

1,200 to 1500 mg

Question 2

Recommended calcium intake recommended for women 25-50 yrs

Answer 2

1,000 mg

Question 3

Recommended calcium intake recommended for post menopause not on HRT

Answer 3

1,500mg

Question 4

What do osteoporosis medications do

Answer 4

• slow down or stop bone loss or rebuild bone/ slows down the remodeling process
• reduce the chances of broken bones
• for medications to work, a person still needs to get enough calcium

Question 5

3 types of osteoporosis meds

Answer 5

Bisphosphonates
Calcitonin
Estrogen receptor modulator

Question 6

What does bisphosphonates do

Answer 6

Antiresorptive

Slowing down the remodeling process

Question 7

Examples of bisphosphonates

Answer 7

Fosamax
Boniva
Actonel
Reclast

Question 8

After taking bisphosphonates the person must be able to

Answer 8

Sit up for an hour

Question 9

Side affects of bisphosphonates

Answer 9

Heartburn
Abdominal pain
Irritated esophagus

Question 10

Risk factors from bisphosphonates

Answer 10

Rare type of femur fractures:
Subtrochanteric fx
Diaphicele fx

Question 11

Brand of calcitonin

Answer 11

Miacalcin

Question 12

Estrogen receptor modulator is aka

Answer 12

Raloxifene

Question 13

Brand of Estrogen receptor modulator

Answer 13

Evista

Question 14

Advantages of Estrogen receptor modulator

Answer 14

Reduce fats in blood, cholesterol

Question 15

Side affects of Estrogen receptor modulator

Answer 15

Hot flashes
Leg cramps
Blood clots

Question 16

What is Juvent

Answer 16

Used to tx osteoporosis by sending electrical impulses up into body to stimulate bone growth

Question 17

Name bone densitometry tests

Answer 17

1. Quantitative measurement of bone density
2. Bone Mineral Density Test
3. Plain skeletal radiographs
4. Quantitative Ultrasound
5. Quantitative computed tomography

Question 18

Quantitative measurement of bone density is the measurement of

Answer 18

Weight bearing bones: hip and spine

Can also measure forearm, wrist, finger, heel

Question 19

BMD is used for?

Answer 19

1. Checks bone mineral content
2. Used to confirm diagnosis of osteoporosis
3. Can predict a persons chances of breaking a bone in the future
4. Determine whether a person’s bone density is increasing decreasing or remaining the same
5. Can monitor a person’s response to treatment

Question 20

FRAX

Answer 20

Fracture risk assessment tool

Question 21

BMD T-score

Answer 21

1. Compares your bone density to a young normal healthy 30 year old with peak bone density
2. T score indicates how much your bone density is above or below normal
3. T score is used by healthcare providers to diagnose osteoporosis

Question 22

Normal T score

Answer 22

Between +1 and -1

Question 23

T score indicating low bone density or osteopenia

Answer 23

Between-1 and -2.5

Question 24

T score that is a diagnosis of osteoporosis

Answer 24

-2.5 and lower

Question 25

BMD Z score

Answer 25

1. Compares your bone density to what is normal in someone your age and body size 2. Is not used to diagnose osteoporosis

Question 26

The bone density unit is called

Answer 26

Dual Energy X-ray Absorptiometry DXA DEXA

Question 27

How does DXA work?

Answer 27

1. Works on the principle of x-ray attenuation effect, separation of soft tissue and bone 2. Two different photon energies are used to differentiate soft tissue and bone

Question 28

2 common types of dexa

Answer 28

1. Pencil beam (circular pinhole); narrow stream of X-ray that goes across body and back and forth 2. Array Beam ( fan-beam) Has a narrow slit Beam moves up towards head

Question 29

C-arm array beam

Answer 29

Less common Multiple detectors Can scan at more than one plane

Question 30

When does plain skeletal radiographs show visual bone demineralization

Answer 30

When bones have demineralized 40%

Question 31

How does quantitative ultrasound measure bone density

Answer 31

It is used to determine how sound waves travel through the bone

Question 32

How does quantitative computed tomography measure bone density

Answer 32

This test uses CT scanner with special software designed to perform bone density studies

Question 33

Place that you position for a hip dexa

Answer 33

Ward's Triangle

Question 34

Reason why we would do a forearm scan

Answer 34

If the patient had bilateral hip prosthetics

Question 35

Type of bone that is dense, outer shell

Answer 35

Cortical/ compact

Question 36

Type of bone that is delicate lattice work

Answer 36

Trabecular / cancellous

Question 37

What type of bone supports weight and accounts for 80% of bone mass

Answer 37

Cortical / compact

Question 38

Type of bone that gets destroyed from osteoporosis

Answer 38

Trabecular / cancellous

Question 39

2 stages of remodeling process

Answer 39

Resorption | Formation

Question 40

Resorption

Answer 40

Osteoclasts breakdown bone and remove old bone leaving pits

Question 41

Formation

Answer 41

Osteoblasts fill in Pitts with new bone

Question 42

How long does the resorption process take

Answer 42

One week

Question 43

How long does the formation process take

Answer 43

One month

Question 44

Five symptoms of osteoporosis

Answer 44

``` Back pain Loss in height Stooped posture Curved back / humpback/ Dowager's hump Fracture of hip vertebrae and wrist are most common ```

Question 45

Risk factors for osteoporosis

Answer 45

``` Family history Being female Menopause Caucasian or Asian descent Thin or small build Life style risk factors include smoking, excessive drinking, not enough exercise, diet low in calcium ```

Question 46

What medication types increase risk factors for osteoporosis

Answer 46

Hyperthyroidism – have problem absorbing calcium Asthma – COPD steroids long term Patients taking steroids for other reasons