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| Combined cost of hospital and social care for patients with a hip fracture amounts to more than |
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| True or false The combined cost of hospital and social care for patients with a hip fracture amounts to more than £1.73 billion per year in the UK. |
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| Osteoporosis is defined as |
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| the value of bone mineral density (BMD) that is more than 2.5 SD below the young adult mean value |
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| The term "primary osteoporosis" denotes |
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| reduced bone mass and fractures in postmenopausal women (postmenopausal osteoporosis) or in older men and women due to age-related factors |
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| The term "secondary osteoporosis" refers to |
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| refers to bone loss resulting from specific clinical disorders, such as thyrotoxicosis or hyperadrenocorticism |
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| An abnormal outward curvature of the vertebrae of upper back. Compression of the front (anterior) portion of the involved vertebrae leads to forward bending of the spine (kyphosis) and creates a hump at the upper back. Dowager's hump is due to osteoporosis changes in the thoracic spine. It may affect men or women. |
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| Sequesters RANKL therefore reducing osteoclast differentiation. |
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| estrogen deficiency has what on PTH |
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Definition
| sensitizes bone to the effects of parathyroid hormone (PTH). |
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| 1,25-dihydroxyvitamin D (1,25[OH]2 D) is what? and does what? |
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| vitamin D that optimizes calcium and phosphorous absorption from the gut, inhibits parathyroid hormone synthesis, and plays a minor role in bone resorption. |
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| Bence Jones protein are indicative of what? |
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| Dual-energy x-ray absorptiometry (DXA) is the standard study used to establish or confirm a diagnosis of osteoporosis, to predict future fracture risk, and to assess changes in bone mass over time. DXA is used to calculate bone mineral density (BMD) at the hip and spine. |
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| Bisphosphonates are synthetic analogues of the naturally occurring compound pyrophosphate. They are potent antiresorptive agents that bind to hydroxyapatite crystals on the surface of bones, enter osteoclasts, and decrease resorptive actions by reducing the production of hydrogen ions and lysosomal enzymes. |
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| Selective estrogen receptor modulators (SERMs), name one? |
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Definition
| tamoxifen, toremifene, and raloxifene |
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| is a peptide hormone that inhibits osteoclast activity and therefore inhibits bone resorption. |
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| active metabolite of vitamin D stimulates calcium absorption and may stimulate osteoblasts directly |
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| Medications known to cause or accelerate bone loss |
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Definition
o Corticosteroids - Prednisone (³ 5 mg/d for ³ 3 mo)23
o Anticonvulsants - Phenytoin, barbiturates, carbamazepine (These agents are associated with treatment-induced vitamin D deficiency.)
o Heparin (long-term)
o Chemotherapeutic/transplant drugs - Cyclosporine, tacrolimus, platinum compounds, cyclophosphamide, ifosfamide, methotrexate
o Hormonal/endocrine therapies - Gonadotropin-releasing hormone (GnRH) agonists, luteinizing hormone-releasing hormone (LHRH) analogs, depomedroxyprogesterone, excessive thyroid supplementation
o Lithium
o Aromatase inhibitors - Exemestane, anastrozole |
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