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Osteoporosis is a “silent” disease characterized by low bone mass, microarchitectural deterioration of bone, susceptibility to fx, People may not know they have OP until they have a fx
Define Osteopnea low bone mass (for person’s age sex or race)
Define Osteomalacia “soft” bone, loss of mineralized bone
What is the most common site for OP? the vertebral bodies, followed by the hips and wrists
A pathological fracture of OP is due to what? or macro-trauma to weakened bone over time
A Rx for OP includes... – vertebral body: avoid flexion, brace, avoid strain on back – Hip: usually surgery – Wrist: immobilization or ORIF; post-cast PT
why will most pathological fractures due to OP heal anyway eventhough it is a degenerative condition because the healing process overrides the pathological process
Which type of OP is postmenapausal? TYPE 1
Which type of OP is senile OP? TYPE 2
The rate of loss of cortical and trabecular bone is ~equal in this type of OP. TYPE 2
THis type of OP has an accelerated & disproportionate loss of trabecular bone TYPE 1
this type of OP occurs most often in women after menapause TYPE 1
This type of OP occurs most men and women but ____ are generally affected a decade earlier than _______. women are affected earlier than men in type 2
Type 1 OP is characterised by... increased bone resorption, reduced production of parathyroid hormone (PTH), and decreased Vitamin D activation leading to impaired absorption and homeostatic regulation of calcium.
Type 2 OP is characterised by... Both the formation and resorption of bone are depressed. While PTH levels are frequently elevated, both osteoblast functioning and calcitriol synsthesis may be diminished.
In which type of OP are hip fractures common? TYPE 2
Other forms of OP include...(5) Osteogenesis imperfecta, nutritional deficiency OP, medication induced OP, Disuse OP, and OP caused by chronic diseases
Nutritional deficient OP may be caused by the following things. Inadequate calcium, protein, Vit C & D in diet. Close to 50% of women have inadequate calcium in diet; poorer intake w/aging excessive ETOH, Gastric bypass.
Medication induced OP may be caused by... glucocorticoids, heparin, anticonvulsants2nd most common type of OP
Dissuse OP may be caused by... secondary to prolonged immobilization, bed rest, or weightlessness... can occur c/in 2 weeks.
Chronic Diseases that may cause OP include... Leukemia, lymphoma, mast cell tumors, bone marrow tumors, endocrine disorders, ankylosing spondylitis, SOPD, HIV, Inflamm bowel disease, MM, RA, renal failure, SLE
Endocrine and metabolic disorders that can cause OP include • Athletic amenorrhea, Cushing syndrome, Diabetes mellitus, type 1 Hemochromatosis, Hyperadrenocorticism, Hyperparathyroidism (primary),Hyperthyroidism, Hypogonadism (primary and secondary), Hypophosphatasia
Function of bones are... 1. protection of organs 2. site for ms insertions3. repair and remodel in response to changing stressors4.serves as a metabolic reservoir for Ca++, P, Mg, Na, and carbonate
the compact layer that forms the outer shell of bone (80% of adult skeleton). The long bones are primarily made of these cortical bone
(20%) consists of a series of plates (spongy) forming the interior meshwork of bone. The vertebrae are mostly composed of these cancellous, trabecular
What % of the skeleton is composed of inorganic ions? 30%
what % of the skeleton is made of protein and collagen 70%
What is the function of Ca++ and P in bone health? Ca and P in the body are found in bone as mineralized structures that provide rigidity
How can Ca++ be lost by the body? urine, sweat, poop
If you are > 50 y/o, how much Ca++ should you get in your diet? 1,200 mg
What foods are good sources of Ca++? Dairy, spinach, greens, and molasses
Name 4 things that provide homeostatic regulation of Ca++ GI tract, kidney, bone, vitamin D(required to maintain CA++ absorption from diet and for the normal mineralization of bone)
People who avoid sunlight have to sub by consuming how much? 5000IU daily
How many men will have a hip fx due to OP? 1 in 8 men will have an osteoporotic fx in his lifetime, accounting for 30% of hip fx
OP and osteopnea are increasing due to # of elderly and baby boomers
Risk factors for OP besides the ones i already know high protein and or sodium intake, asians, Inflammatory form of arthritis or related condition, certain meds
What is orthonea. the number of pillows that must be used for ppl to breath properly while sleeping if they have a compensated ribcage due to vertebral fractures and spine flexion.
What happens during a vertebroplasty? they go into the collapsed vert w/ a balloon & inject glue that surrounds the balloon
Px for a pt with OP poor to fair
What is DEXA (bone mineral density scan) used for? – 1. Used to detect osteoporosis before a fracture occurs– 2. to help predict future fractures– 3. to determine the individual’s rate of bone loss– 4. to monitor the effects of Rx if the test is conducted at intervals of a year or more
RX for pts c OP PREVENTION...• Educate pts to encourage healthy behaviors & promote preventive practices...estrogen therapies(Inc. intestinal CA absorption, reduces urinary CA excretion, inhibits bone resorption, dec. bone turnover) WB ex.30minx5-7d/w, cardio+strength
What is Wolff’s Law "The densities, and to a lesser extent, the sizes and shapes of bones are determined by the magnitude and direction of the acting forces applied to bone"
Created by: PTROCKS