Osteoporosis
Terms
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- Risk factors and how to assess osteoporosis
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Diet
Physical Activity
Reproductive Status
Smoking, Alcohol
Immobility
Systemic Illness
Age, Sex, Meds, Genetics
Test with DEXA SCAN - What pathologic processes increase risk for osteoporosis
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Dx of increased PTH: HyperPTH
Malignancy
Dx of Decrease in Vit D
Cushing's
DM1
Adrenal Insufficiency
Dx of Sex hormones
Anorexia
Beta Thalassemia - Describe the role of male gonadal hormones in determining peak bone density
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Timing and onset of puberty,
Testosterone increases the size and strength of bones and increase bone density - Describe Risk factors for male osteoporosis
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Hypogonadism
Renal Calcium Leak
HyperProlactinemia
Chronic Alcoholism - Tx Options for male osteoporosis
- Androgens are given vs estrogen replacement therapy for girls. Teriparatide, which is an rPTH is also given as a daily injection
- describe the timing of puberty with the determination of peak bone density
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delayed puberty = impaired peak bone density
Constitutional delay have lower bone densities compared to normal onset puberty. once epiphyseal plates close, the ability to increase bone density decreases. - Describe the clinical presentation of hypercalcemia
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hypertension and bradycardia
proximal muscle weaknes
bony tenderness to palpation
anorexia or nausia
hyperreflexia/tongue fasciculations
lethargy/stupor - Describe the clinical presentation of Hypocalcemia
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TETANY
numbness and tingling of extremities
carpopedal spasm
laryngeal stridor
tremor/chorea
siezures - Describe the clinical presentation of vit D deficiency
- Similar to hypocalcemia
- Describe the clinical presentation of bone matrix abnormalities
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osteoporosis: fractures of the spine, wrist, and hip.
vertebral bodies are crushed, resulting in loss of height
Osteomalacia: weakness, fracture, pain, anorexia, weight loss - Describe the clinical presentation of Paget's Disease
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increased skeletol warmth
bowing deformities
hyperexpansion of the skull
spinal cord compression
Hearing loss due to compression of the cochlear nerve