Term
| a metabolic skeletal disorder in which reduced bone mass and increased bone fragility lead to an increased risk of fractures, disability and death |
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Definition
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Term
| In osteoporosis, bone is lost more quickly through the _ than it can be produced resulting in reduced _ |
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Definition
| remodeling process, bone mineral density |
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Term
| cells that break down bone |
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Definition
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Term
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Definition
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Term
| In addition to osteoclasts and osteoblasts, bone remodeling is affected by |
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Definition
| vitamin D and calcium levels, stress on bones |
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Term
| _ inhibits bone resorption |
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Definition
| estrogen and testosterone |
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Term
| throiugh the regulation of _ PTH increases production of _ |
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Definition
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Term
| There are two types of osteoporosis: |
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Definition
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Term
| Primary osteoporisis may either be: |
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Definition
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Term
| Type 1 osteoporosis is associated with |
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Definition
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Term
| Type 2 osteoporosis is associated with decreasing bone formation that accompanies the: |
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Definition
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Term
| has been linked to estrogen deficiency resulting in increased calcium reabsorption from bone as the lack of estrogen renders the body more sensitive to PTH |
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Definition
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Term
| typically results as the kidnesy lose their ability to rpocess vitamin D, causing decreased calcium absorption, which in turn increases sensitivity to PTH and bone reabsorption |
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Definition
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Term
| occurs as the result of a disease process or a deficiency or as an effectct of a drug that affects calcium, vitamin D, or sex hormones |
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Definition
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Term
| _ is anohter common cause of secondary ostoporosis and is treated with _ |
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Definition
| renal hypercaciuria, thiazide diuretics |
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Term
| Many patients with primary osteoporsis also have one or more scondary factors such as: |
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Definition
| cushing syndrome, adrneal insufficiency, calcium deficiency or DM |
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Term
| Majority of calcium in the body is stored in the |
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Definition
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Term
| When a person consumes a diet low in calcium _ secretion is _ promoting a breadown of _ in the bone and a release of _ in the blood stream |
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Definition
| PTH, increased, osteoclasts, calcium |
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Term
| _ increses the absorption of calcium in the _ to the bloodstream |
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Definition
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Term
| Vitamin D is produced in the _ with exposure to _ from the sun for as little as _ per day |
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Definition
| skin, ultraviolet rays, 10 to 15 minutes |
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Term
| Eating disorders such as _ may aggravate ostoporosis |
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Definition
| anorexia nervosa and bulimia |
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Term
| Individuals with a BMI less than _ have greater bone loss and higher risk of fractures irrespective of age, sex, or weight loss |
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Definition
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Term
| Chronic alcoholism is associated with deficicencis of: |
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Definition
| calcium, protein and vitamin D |
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Term
| Osteoporosis is often called a _ because the early stages may produce no symptoms |
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Definition
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Term
| Common manifestations that occur with bone loss in osteoporosis include: |
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Definition
| fractures, back pain, loss of height and stooped posture |
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Term
| the presence of a _ due to low bone mineral density may be the first sign of osteoporosis |
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Definition
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Term
| a fracture that occurs from mild impact |
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Definition
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Term
| ostoporotic fractures typically occur in the |
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Definition
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Term
| vertebral fractures may cause: |
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Definition
| loss of height, back pain, functional limitations and spinal deformity |
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Term
| In inidviduals with ostoporosis, vertebral fractures often occur while performing daily activities such as |
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Definition
| bending, lifting or sneezing |
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Term
| as vertebral bodies collapse, _ and _ producing a stoped or hunched apperance alson know as a _ |
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Definition
| dorsal kyposis, cervical lordosis, dowagers or buffalo hump |
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Term
| forward curve of the spine |
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Definition
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Term
| exessive inward curve of the neck |
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Definition
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Term
| the goals of care for the paitent with osteoporosis is to: |
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Definition
| slow or halt the procession of bone fragility, reduce syptoms and prevent complications |
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Term
| The plan of care for osteoporosis includes |
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Definition
| pharmacologic agents, proper nutrition and an activity program |
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Term
| In asymptomatic individuals, the gold standard of diagnosisng osteoporosis is through: |
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Definition
| dual energy x-ray absorptiometry (DEXA) |
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Term
| The results of DEXA are reported as _ scores which are standard deviations from a young healthy persong |
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Definition
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Term
| A T score of _ or below the standard is indicative of low bone density and osteoporosis in _ |
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Definition
| -2.5, postmenopausal women and in men +50 years of age or older |
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Term
| Individuals with or at risk for osteoporosis should also limit intake of foods that adversely affect bone strength such as: |
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Definition
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Term
| the focus of pharmacologic treatment for osteoporosis is to reduce the risk of bone fractures through the use of: |
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Definition
| antiresorptive or anabolic drugs |
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Term
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Definition
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Term
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Definition
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Term
| antiresorptive treatment inclcudes: |
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Definition
| bisphophonates, RANKL inhibitors, and selective estrogen receptor modulators |
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Term
| anabolic treatment includes: |
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Definition
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Term
| _ may be given with drugs to treat osteoporos as adjunct therapy |
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Definition
| calcium and vitamin D supplements |
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Term
| Drugs for osteoporosis may be administered for up to _ followed by a reassessment of the need for continued treatment |
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Definition
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Term
| _ inhibit bone resorption and slow the breakdown of bone reducing the risk of fractures in the _ |
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Definition
| Bisphonates; hip, vertebral and nonvertebral bones |
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Term
| Bisphosphonates are typicall first line therapy for prevention and treatment of ostteoporosis in _, treatment of _, and prevention and tretment of _ |
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Definition
| postmenopausal women; men with osteoporosis; glucocorticoid -induced osteoporosis |
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Term
| Oral calcium supplements are best taken with |
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Definition
| with meals or within 1 hour following meals |
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Term
| National ostoporosis foundation recommends _ for women age _ and younger, and men age _ and younger, and _ for women age _ and older, and men age _ and older |
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Definition
| 1000mg/day; 50; 70; 1200; 51; 71 |
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Term
| symptoms of hypercalcemia |
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Definition
| lethargy, drowsiness, weakness, headache, anorexia, nausea/vomiting, increased urination and thirst |
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Term
| calcium supplementation is contraindicated in patients with; |
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Definition
| ventricular fibrillaion, metastatic bone cancer, renal calculi or hypercalcemia |
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Term
| caution should be taken in administering calcium supplements with: |
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Definition
| digoxin, tetracyclines and calcium channel blockers |
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Term
| inhibit the normal cation of PTH that stimulates osteoclasts and causes bone rsorption |
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Definition
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Term
| Calcitonin hormones can be injected _ or administered as a _ |
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Definition
| subcutatneously, nasal spray |
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Term
| anabolic drugs that promote bone formation and increae bone mineral density |
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Definition
| parathyroid hormone analogs |
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Term
| Parathryoid hromone analogs whose action mimic those of _ reduce the risk of _ fractures in postmenopausal womena at high risk, but the carry a risk for developing _ |
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Definition
| PTH; vertebral and novertebral fractures; osteosarcoma |
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Term
| Parathyroid hormone analogs are typically given for up to _ followed by treatment with drugs that _ |
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Definition
| 2 years; inhibit bone resorption |
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Term
| Since PTH anaologs can cause hypercalcemia, _ should be checked before starting therapy |
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Definition
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Term
| PTH analogs should not be prescribed to treat patients with: |
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Definition
| renal impairment, bone malignances or paget disease |
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Term
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Definition
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Term
| RANKL inhibitors are monoclonalantibodies that are used to treat _ at high risk for fracturs |
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Definition
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Term
| Denosumab is also used to treat _ with osteoporsis and men and women with ostoporosis caused by _ |
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Definition
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Term
| _ is also indicated for those who cannot tolerate oral therapy |
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Definition
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Term
| _ work by inhibiting maturation of osteoclasts |
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Definition
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Term
| RANKL inhibitors are administered: |
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Definition
| subcutaneously every 6 months |
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Term
| Correction of the _ should be done before starting denosumab since it can cause _ |
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Definition
| calcium levels; hypocalcemia |
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Term
| inicated for the treatment of osteoporosis in postmenopausal women |
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Definition
| Selective estrogen receptor modulators (SERMs) |
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Term
| SERMs activate estrogen hormone receptors in the _ decresing bone _ and increasing bone _ |
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Definition
| bone; resorption and bone turnover; density |
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Term
| SERMs should not be administered to: |
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Definition
| pregnant or premenopausal women, to men, or those at risk for deep vein thrombosis and stroke |
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Term
| An adequate level of _ in the body is important for bone density because it helps the body absorb the minerals _ |
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Definition
| vitamin K; calcium and phosphorus |
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Term
| Exposure to sunlight helps make both _ in the skin |
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Definition
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Term
| Vitamin D recommendations are _ international units for men and women under age 50 and _ international untis for men and women age 50 and older |
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Definition
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Term
| when diagnosed in the pediatric patient, osteoporosis is often referered to as: |
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Definition
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Term
| children at reisk for developing ostoprosis include those with |
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Definition
| reduced mechanical loading |
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Term
| Reduced mechanical loading tends to occur in patients with dagnoses such as_ as these disease processes interfere with ambulation, which cause limited pressure on the bones |
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Definition
| spina bifida or cerbral palsy |
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Term
| conditions associated with lower bone mass |
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Definition
| turner syndrome, GH deficiency, osteogenesis imperfecta, juvenile rheumatoid arthritis and diabetes |
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Term
| The leanness found in many adolescent female athletes increases the risk for female athlete triad, a combination of: |
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Definition
| low bone mass, disordered eating and amenorrhea |
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Term
| calsium rich sources of food include: |
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Definition
| dairy products, green vegetables such as broccoli and curly kale, fruits such as oranges, apricots and dried figs, canned fish with soft bones and nuts |
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Term
| some calcium enriched foods are available such as |
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Definition
| bread, cereal and orange juice |
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Term
| vitamin D may be found in |
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Definition
| oily fish such as: salmon, sardines and mackerel; eggs, liver and vitamin d fortified foods |
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Term
| Low impact exercises such as _ do not impact bone loss |
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Definition
| walking, swimming, cycling |
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Term
| can maintain or improve bone mineral densisty in postmenopausal women |
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Definition
| progressive restance training |
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Term
| improves functional abilityies such as rising form a chair and stair climbing in older adults |
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Definition
| high velocity power training |
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Term
| can reduce the risk of falls through flexibility and balance trainign |
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Definition
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Term
| Bisphosphonates should be taken _ on an _ stomach, followed by a _ |
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Definition
| in the morning, empty, full glass of water |
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