Osteoporosis

Question 1

osteoporosis

Answer 1

bone cavity formation d/t l/o bone mass –> inc fragility to bones –> fracture

Question 2

etiology

Answer 2

multifactorial (complex):

• genetic predisposition (Peak Bone Mass)
• aging (bone loss begins at ~30 yrs)
• l/o estrogen at menopause

Question 3

risk factors

Answer 3

1) low peak bone mass (BPM)

2) post menopausal women (inc bone loss) –> estrogen prod dec

Question 4

why does dec estrogen production inc risk for osteoporosis

Answer 4

Estrogen has protective effect on bone, involved in maintaining balance b/w osteoblast & osteoclast activity –> produces mediators to inhibit osteoclast activity & regulate breakdown

• l/o estrogen = dec osteoclast formation

Question 5

patho

Answer 5

• imbal b/w formation & resorption of bone –> ongoing l/o bone
• microdamage –> bone internally damaged
• most changes occur in diaphysis & metaphysis (where most bone growth occurs)

Question 6

mnfts

Answer 6

• asympt (until bone fracture)
• reduced height & change in stature
• dyspnea
• loose & degraded teeth
• pain (early mnft)

Question 7

why does reduced height & change in stature mnft

Answer 7

Vertebrae loses bone mass

Question 8

why does dyspnea mnft

Answer 8

External pressure applied on ribcage d/t hunched stature –> inhibit lung expansion

Question 9

cmplx of loose & degraded teeth (mnft)

Answer 9

Cannot chew hard foods –> impacts diet –> dietary deficiencies

Question 10

Dx

Answer 10

• bone density scans
• X-ray
• DEXA (Dual-energy X-ray Absorptiometry)

Question 11

bone density scans

Answer 11

• Principle of scan is passing photos of light through bone (if bone less dense, more light passes through)
• Usually use lumbar spine, radius, and neck of femur
• Detects degree of absorption of light

Question 12

Tx

Answer 12

• prevent bone loss & early detection
• adequate calcium & vit D consumption
• weight-bearing activities

pharmacology:
- antiresorptive agents
- anabolic agents

Question 13

why is weight-bearing activity a Tx

Answer 13

it stimulates osteoclast activity (same action as estrogen)

ex. brisk walking, jogging, etc.

Question 14

antiresorptive agents

Answer 14

inhibits osteoclast activity (same action as estrogen)

Question 15

anabolic agents

Answer 15

enhances osteoclast activity (more bone deposition to outweigh breakdown)

Question 16

cmplx

Answer 16

fractures

• long healing time b/c ossification required
• prevention of fractures important part of osteoporosis management