Osteoporosis

Vocabulary flashcards covering the definition, prevalence, risk factors, pathophysiology, clinical manifestations, diagnostic studies, and collaborative care, including nutritional, exercise, and pharmacological interventions, for osteoporosis.

Osteoporosis

A chronic, progressive metabolic bone disease characterized by porous bone, low bone mass, structural deterioration of bone tissue, and increased bone fragility.

Prevalence of Osteoporosis

At least 10 million people in the United States; one in two women and one in eight men over 50 will sustain an osteoporosis-related fracture.

Reasons for Higher Incidence of Osteoporosis in Women

Lower calcium intake, less bone mass due to smaller frame, earlier and accelerated bone resorption after menopause, depletion of skeletal calcium reserves by pregnancy and breastfeeding, and increased longevity.

Risk Factors for Osteoporosis

Female gender, increasing age, low body weight, White or Asian ethnicity, family history, early menopause, excess alcohol intake, cigarette smoking, sedentary lifestyle, insufficient calcium intake, long-term use of corticosteroids, thyroid replacement, or antiseizure drugs, and low testosterone levels in men.

Peak Bone Mass

Achieved before age 20, determined by heredity, nutrition, exercise, and hormone function.

Drugs that Interfere with Bone Metabolism

Corticosteroids, antiseizure drugs (e.g., valproate, phenytoin), aluminum-containing antacids, certain cancer treatments, and excessive thyroid hormones.

Pathophysiology of Osteoporosis

Bone resorption exceeds bone deposition, commonly occurring in the spine, hips, and wrist.

Dowager's Hump (Kyphosis)

A humped back caused by wedging and fractures of vertebrae, leading to gradual loss of height in osteoporosis.

First Signs of Osteoporosis

Back pain and spontaneous fractures, as it is often termed the 'silent disease' due to lack of symptoms.

Diseases Associated with Osteoporosis

Intestinal malabsorption, kidney disease, rheumatoid arthritis, hyperthyroidism, chronic alcoholism, cirrhosis of the liver, hypogonadism, and diabetes mellitus.

Clinical Manifestations of Osteoporosis

Sudden strain, fractures, back pain, loss of height, and spinal deformities (e.g., kyphosis).

Diagnostic Studies for Osteoporosis

History and physical exam, bone mineral density (BMD) measurement, quantitative ultrasound (QUS), and dual-energy x-ray absorptiometry (DEXA).

Osteoporosis (Diagnostic Criteria)

A bone mineral density (BMD) ≤-2.5 standard deviations below a young adult BMD.

Osteopenia

More than normal bone loss but not yet at the level of osteoporosis.

Collaborative Care for Osteoporosis

Focuses on proper nutrition, calcium supplements, exercise, prevention of fractures, and drug therapy.

Role of Calcium in Osteoporosis Management

Adequate calcium intake is crucial for prevention and treatment; it prevents future bone loss but does not form new bone.

Good Dietary Sources of Calcium

Milk, yogurt, turnip greens, spinach, cottage cheese, ice cream, and sardines.

Recommended Exercises for Osteoporosis

Weight-bearing exercises such as walking, stair climbing, and dancing to build up and maintain bone mass.

Drug Therapy for Osteoporosis

Includes calcium, Vitamin D, calcitonin, bisphosphonates (e.g., etidronate, alendronate), selective estrogen receptor modulators (e.g., raloxifene), and teriparatide.

Bisphosphonates

A class of drugs (e.g., etidronate [Didronel], alendronate [Fosamax]) that inhibit osteoclast-mediated bone resorption in osteoporosis treatment.

Teriparatide (Forteo)

A portion of parathyroid hormone, notable as the first drug developed to stimulate new bone formation in osteoporosis.

Lifestyle Modifications for Osteoporosis

Quitting smoking or reducing alcohol intake to decrease bone mass loss, in addition to proper nutrition and exercise.