Term
| economic impact of osteoporosis |
|
Definition
| prevalence: 10 million; annual direct cost inc hospitalization: 13.8; sim to that of treating CV disease and asthma |
|
|
Term
| most common fracture type |
|
Definition
|
|
Term
|
Definition
| less than 1/3 of pts with OP are identified or treated; bone density test & Rx: 21% |
|
|
Term
| what is a barrier to treatment of OP? |
|
Definition
|
|
Term
| causes of inadequate peak bone mass |
|
Definition
| genetic, nutrition, physical activity, diseases or drugs, hormones, alcohol/tobacco use, immobilization, vit d deficiency |
|
|
Term
| Screening Guidelines, PSTF: DXA |
|
Definition
| women > 65: "B" rating, all women < 65: "B" rating; men aged > 70: "I" rating (although not PSTF) |
|
|
Term
| National Osteoporosis Foundation recommendations |
|
Definition
| BMD testing for all women > 65 and postmenopausal women < 65, based on risk factor profile |
|
|
Term
|
Definition
| dual energy X-ray absorptiometry |
|
|
Term
|
Definition
| quantitative ultrasoun (QUS): lower cost, portability, no radiation |
|
|
Term
| risk factors for calculation of 10-year risk of fracture for OP |
|
Definition
| femoral neck T-score, age, previous low trauma fracture, low BMI, ever steroid exposure, family hx of hip fracture, current smoker, high alcohol intake |
|
|
Term
|
Definition
| provides a quantitative estimation of fracture risk using BMD and CRFs |
|
|
Term
| 3 strategies for reducing fracture risk: |
|
Definition
| pharmacological intervention, calcium and vit D, injury prevention |
|
|
Term
| OP pharmacological treatment objectives: |
|
Definition
| osteoclast (inhibition of resorption); osteoblast (stimulation of formation) |
|
|
Term
| Non-pharmacological approaches to prevent postmenopausal OP |
|
Definition
| adequate Ca and protein, reg physical activity, minimize alcohol, minimize risk of fall, recommend hip protectors |
|
|
Term
| a risk factor for falling: |
|
Definition
|
|
Term
| probs of monitoring tx of osteoporosis with DXA |
|
Definition
| slow response; increase in BMD may not be an adequate surrogate marker of efficacy of all treatments |
|
|
Term
| NOF Osteoporosis treatment guidelines |
|
Definition
| postmenopausal women and men age 50+ with the following should be considered for treatment T-score: 2.5 or less |
|
|
Term
| when FRAX can be used to estimate fracture risk: |
|
Definition
| untreated women and men btwn age 40-90 |
|
|
Term
| when to use FRAX with the NOF guideline |
|
Definition
| UNTREATED postmenopausal women and men age 50 and older with osteopenia who do not qualify for tx based on other tx indications |
|
|
Term
| when NOT to use FRAX with the NOF guide |
|
Definition
-pts who meet other treatment indications
-treated pts
-t-score normal or osteoporosis
-premenopausal women, men under age 50, children |
|
|
Term
| approaches to BMD testing for selecting pts for treatment |
|
Definition
-women age 65+
-men age 70+
-other's with CRF's |
|
|
Term
| factors for decision to treat |
|
Definition
1. PUBLIC HEALTH FACTORS
-fracture probability
-cost effectiveness
2. PATIENT FACTORS
-efficacy and safety for indiv pt
-non skeletal risk and benefits
-co-morbidities
-expected adherence to therapy
-patient belief and preference
-insurance coverage and affordability |
|
|
Term
| biophosponate adverse events |
|
Definition
-acute phrase response
-upper GI
-rash
-iritis
-renal impairment
-jaw osteonecrosis |
|
|
Term
| probs with monitoring treatment of OP with DXA |
|
Definition
1. slow response
2. increase in BMD may not be an adequate surrogate marker of efficacy of all treatments |
|
|
Term
| for treatment of secondary osteoporosis in men: |
|
Definition
1. androgens
2. limit corticosteroid therapy, alcoholism or smoking
3. use thiazides for hypercalciuria |
|
|
Term
|
Definition
| by age 20, acquired 98% of skeletal mass |
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