Top Banner

Click here to load reader

 “Silent disease” until complicated by fractures  Most common bone disease in humans  Characterized by:  Low bone mass  Microarchitectural deterioration

Dec 16, 2015

ReportDownload

Documents

  • Slide 1
  • Slide 2
  • Silent disease until complicated by fractures Most common bone disease in humans Characterized by: Low bone mass Microarchitectural deterioration Compromised bone strength Increased risk for fracture
  • Slide 3
  • Major History of fracture as an adult Fragility fracture in first degree relative Caucasian/Asian postmenopausal woman Low body weight (< 127 lb) Current smoking Use of oral corticosteroids > 3 mo. Additional Impaired vision Estrogen deficiency at early age (< 45 YO) Dementia Poor health/frailty Recent falls Low calcium intake (lifelong) Low physical activity > 2 alcoholic drinks per day
  • Slide 4
  • COPD Cushings syndrome Eating disorders Hyperparathyroidism Hypophosphatasia IBS RA, other autoimmune connective tissue disorders Insulin dependent diabetes Multiple sclerosis Multiple myeloma Stroke (CVA) Thyrotoxicosis Vitamin D deficiency Liver diseases
  • Slide 5
  • Aluminum Anticonvulsants Cytotoxic drugs Glucocorticosteroids (oral/high dose inhaled) Immunosuppresants Gonadotropin-releasing hormone Lithium Heparin (chronic use) Supraphysiologic thyroxine doses Aromatase inhibitors Depo-Provera
  • Slide 6
  • Common, iatrogenic form of secondary osteoporosis Associated with corticosteroid use in chronic, noninfectious medical conditions Asthma Chronic lung disease Rheumatologic disorders Inflammatory bowel disease Skin diseases
  • Slide 7
  • Bone remodeling occurs throughout adulthood Osteoporosis results from an imbalance between osteoclast and osteoblast activity Two metabolic abnormalities contribute to increased bone resorption Secondary hyperparathyroidism due to decreased GI absorption and urinary excretion of calcium Altered gonadal function and decreased adrenal production of androgens
  • Slide 8
  • Slide 9
  • Glucocorticoid-induced osteoporosis predominantly affects regions of the skeleton that have abundant cancellous bone, such as the lumbar spine and proximal femur
  • Slide 10
  • the loss of bone mineral density is biphasic; it occurs rapidly (6 to 12% loss) within the first year and more slowly (approximately 3% loss yearly) thereafter increase in the risk of fractures has been reported with the use of inhaled glucocorticoids, as well as with alternate-day and intermittent oral regimens
  • Slide 11
  • Advanced age Low body-mass index (
Welcome message from author
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.