30 Questions
At what age is peak adult bone mass typically achieved?
Between 18 and 25 years
What factors can affect peak adult bone mass?
Genetic factors, nutrition, physical activity, medications, endocrine status, and general health
At what age do women typically experience primary osteoporosis?
By age 51
What contributes to the development of osteopenia without associated bone loss?
Failure to develop optimal peak bone mass and low vitamin D levels
What interventions can 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 is secondary osteoporosis the result of?
Medications or diseases that affect bone metabolism
Which gender typically develops larger, heavier bones?
Men
What age range is associated with the manifestation of osteoporosis in men?
At more advanced ages
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 are some interventions that can decrease the risk of fractures and associated disability later in life?
Participation in regular weight-bearing exercise and modification of lifestyle
Which group of women is at highest risk for osteoporosis?
Small-framed and Asian/Caucasian women
What tool is used to estimate fracture risk and guide treatment decisions?
FRAX and MORES
What contributes to osteoporosis development?
Bariatric surgery
What causes accelerated bone resorption in women?
Estrogen withdrawal at menopause or oophorectomy
What is used to diagnose osteoporosis?
Dual-energy x-ray absorptiometry (DEXA) scans
Who has a greater peak bone mass and experiences osteoporosis later in life?
Men
What contributes to poor bone health?
Autoimmune diseases
At what age is baseline DEXA testing recommended for women?
Over 65
What may be a cause of osteoporosis in men?
Low testosterone levels
When is osteoporosis undetectable on routine x-rays?
Until significant demineralization occurs
What is the prevalence of osteoporosis in women older than 80 years?
50%
What is a fragility fracture?
A fracture caused by a fall from natural height or with low velocity
Why are routine vertebral fracture screenings not recommended for older adults?
80% to 90% of these fractures can be seen incidentally on chest x-rays
What is the primary cause of net bone loss over time?
Both decreased calcitonin and estrogen, and increased parathyroid hormone
What is the primary characteristic of osteoporosis?
Diminished bone architectural strength
What contributes to the greater prevalence of secondary causes of osteoporosis in men compared to women?
Use of corticosteroids and excessive alcohol intake
Why are most residents of long-term care facilities at risk for bone fracture?
They have a low bone mineral density (BMD)
What is the projected trend for the number of hip fractures and associated costs by 2040?
Double
What happens to the rate of bone resorption and bone formation in osteoporosis?
Bone resorption is greater than bone formation
What contributes to the altered absorption and excretion of dietary calcium in older adults?
Decreased absorption and increased excretion
Study Notes
Osteoporosis and Fragility Fractures: Key Points
- Men are more likely than women to have secondary causes of osteoporosis, including the use of corticosteroids and excessive alcohol intake.
- The prevalence of osteoporosis in women older than 80 years is 50%.
- Most residents of long-term care facilities have a low bone mineral density (BMD) and are at risk for bone fracture.
- The number of hip fractures and associated costs are projected to double by 2040 due to the aging of the U.S. population.
- A fragility fracture is defined as one that occurs when a person falls from their natural height or with low velocity.
- Routine vertebral fracture screenings are not recommended for older adults, but 80% to 90% of these fractures can be seen incidentally on chest x-rays.
- Older adults absorb dietary calcium less efficiently and excrete it more readily through their kidneys.
- Osteoporosis is characterized by reduced bone mass, deterioration of bone matrix, and diminished bone architectural strength.
- Normal homeostatic bone turnover is altered in osteoporosis, with the rate of bone resorption maintained by osteoclasts being greater than the rate of bone formation maintained by osteoblasts.
- Compression fractures of the thoracic and lumbar spine, hip fractures, and Colles fractures of the wrist are common in osteoporosis.
- The gradual collapse of a vertebra may be asymptomatic, leading to kyphosis, loss of height, and postural changes.
- Age-related loss of bone mass begins soon after peak bone mass is achieved, with decreased calcitonin and estrogen, and increased parathyroid hormone contributing to net bone loss over time.
Test your knowledge about osteoporosis and fragility fractures with this quiz. Learn about risk factors, prevalence, common fractures, and diagnostic considerations for this bone-weakening condition.
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