30 Questions
At what age is peak adult bone mass achieved in both women and men?
Between 18 and 25 years
What contributes to the development of osteopenia without associated bone loss?
Failure to develop optimal peak bone mass and low vitamin D levels
Who typically develops larger, heavier bones, leading to a later manifestation of osteoporosis?
Men
When does primary osteoporosis occur in women?
After menopause
What is the result of medications or diseases that affect bone metabolism?
Secondary osteoporosis
What interventions decrease the risk of fractures and associated disability later in life?
Increased calcium and vitamin D intake, participation in regular weight-bearing exercise, and modification of lifestyle
What age does menopause usually occur in women?
By age 51
What is the consequence of failure to develop optimal peak bone mass and low vitamin D levels?
Contributes to the development of osteopenia without associated bone loss
What is affected by genetic factors, nutrition, physical activity, medications, endocrine status, and general health?
Peak adult bone mass
What decreases the risk of fractures and associated disability later in life?
Increased calcium and vitamin D intake, participation in regular weight-bearing exercise, and modification of lifestyle
What is the prevalence of osteoporosis in women over 80?
50%
What is the recommended daily calcium intake for older adults?
1200 mg
What is a common consequence of osteoporosis?
Colles fractures of the wrist
What is the impact of aging on calcitonin and estrogen levels?
They decrease
Who is more likely to have secondary causes of osteoporosis?
Men
What is the expected change in the number of hip fractures and associated costs by 2040?
Double
What is the risk of bone fracture for long-term care facility residents?
High
What is the impact of hip fractures on men compared to women?
Higher mortality rate
What is the characteristic of fragility fractures?
Low velocity falls
Are routine vertebral fracture screenings recommended for older adults?
No
What contributes to osteoporosis development?
Nutrition, bariatric surgery, and immobility
How is osteoporosis diagnosed?
Dual-energy x-ray absorptiometry (DEXA)
Who is at highest risk for osteoporosis?
Small-framed, Asian, and Caucasian women
What increases osteoporosis risk for women with breast cancer?
Aromatase inhibitors
How is bone formation enhanced?
Weight and muscle activity
What is recommended for assessing response to osteoporosis therapy?
Bone mineral density (BMD) studies
How is female fracture risk estimated?
WHO Fracture Risk Assessment Tool (FRAX)
When is treatment for osteoporosis recommended?
For those with a 10-year risk of more than 3% for hip fracture or 20% risk for other major fractures
What causes accelerated bone resorption in women at menopause?
Withdrawal of estrogens
How is osteoporosis excluded?
Laboratory studies and x-ray studies
Study Notes
Osteoporosis and Risk Factors Summary
- Withdrawal of estrogens at menopause or oophorectomy causes accelerated bone resorption, with most women losing 10% of bone mass within the first 5 years.
- Small-framed, Asian, and Caucasian women are at highest risk for osteoporosis, while African American women are also at risk due to prevalence of sickle cell and autoimmune diseases.
- Aromatase inhibitors increase osteoporosis risk for women with breast cancer.
- Men have a greater peak bone mass and experience osteoporosis about one decade later than women, with one in four men sustaining an osteopenic fracture.
- Nutrition, bariatric surgery, GI diseases, autoimmune diseases, and immobility contribute to osteoporosis development.
- Bone formation is enhanced by weight and muscle activity, while immobility contributes to osteoporosis development.
- Osteoporosis may be undetectable on routine x-rays until significant demineralization occurs.
- Osteoporosis is diagnosed by dual-energy x-ray absorptiometry (DEXA), with baseline testing recommended for older women and those with risk factors.
- BMD studies are useful in assessing response to therapy and recommended post any osteoporotic fracture.
- Female fracture risk can be estimated using the WHO Fracture Risk Assessment Tool (FRAX), while the Male Osteoporosis Risk Estimation Score (MORES) is more specific for men.
- Treatment is reserved for those with a 10-year risk of more than 3% for hip fracture or 20% risk for other major fractures, based on BMD, personal and family history, and secondary factors.
- Laboratory studies and x-ray studies are used to exclude other possible disorders contributing to bone loss.
Test your knowledge of osteoporosis risk factors, diagnosis, and management with this informative quiz. Learn about the impact of menopause, ethnicity, gender, and medical conditions on bone health, and understand the diagnostic tools and treatment guidelines for osteoporosis.
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