ISCD EXAM STUDY SET | 271 QUESTIONS | WITH
COMPLETE SOLUTIONS.
state the definition of osteoporosis Answer - NEWEST DEFINITION:
"osteoporosis is a skeletal disorder characterized by compromised bone
strength predisposing to an increase risk of fracture. bone strength reflects the
integration of two main features: bone density and bone quality"
Osteoporosis can also be defined based on the presence or history of a low-
trauma or fragility fracture
-2.5 T score or below
what is a fragility/low trauma fracture Answer - a fracture resulting from the
force of a fall from a standing height or less; or a bone that breaks under the
conditions that would not cause a normal bone to break
summarize the pathophysiology of osteoporosis Answer - bone loss occurs
when resorption exceeds formation - this can happen due to a number of
things; age related bone loss, disease related to bone loss (ex: malabsorption
diseases like certain cancers), menopause, lifestyle, etc. as bone loss occurs,
there is loss of quality as well as quantity. WHO classifies osteoporosis as -2.5
or below T-score.
what is the definition of prevalence Answer - frequency of disease at a specific
point in time ("30% of women over age 50 have osteoporosis")
,what is the definition of incidence Answer - new cases of disease over a
specific period of time ("the incidence of hip fractures in an elderly population
is 12 per 1000 person-years")
explain the prevalence and incidence of osteoporosis and fractures Answer -
prevalence of osteoporosis: estimated 200 million people have osteoporosis
worldwide
incidence of osteoporosis: hip fracture projected to increase 240% in women
and 320% in men by 2050
in women, the incidence of clinical vertebral fractures begins to increase
around age 55-60 and rises linearly (5-10 yrs later for men)
in women, the incidence of hip fractures begins to raise about age 65 and
increases exponentially (5-10 yrs later for men)
distal forearm fractures - mortality and morbidity Answer - third most
common osteoporotic fracture
risk increases early in women (age 45-50) and levels off 60-65
most likely caused by fall on outstretched hand
vertebral fracture - mortality and morbidity Answer - VERTEBRAL FRACTURE IS
THE MOST COMMON OSTEOPOROTIC FRACTURE
types: wedge, biconcave, or crush
many occur with everyday activities (lifting, pushing, pulling)
after vertebral fracture, there is a gradual increase in mortality
five-year excess mortality is increased by about 20%
hip fractures - mortality and morbidity Answer - 2nd most common
osteoporotic fracture
,most caused by fall from standing height
24-30% excess mortality within 1 year
five-year excess mortality is increased by about 20%
list the economic costs of osteoporosis and compare with other diseases
Answer - distribution of health care dollars for osteoporosis amount to about
52% for hospitalization, 30% for nursing home care and 13% for outpatient care
osteopenia (low bone density) and osteoporosis: 44 mil
hypercholesterolemia: 98.6 mil
hypertension: 73.5 mil
diabetes: 23.6 mil
explain the value of bone densitometry for diagnosis, fracture risk estimation
and monitoring Answer - for diagnosis of osteoporosis, bone densitometry
allows diagnosis of osteoporosis in asymptomatic individuals prior to fracture
using the WHO classification (-2.5 t score or below)
CAVEATS- some patients with -2.5 or below do not have osteoporosis, while
some patients with above -2.5 may be diagnosed with osteoporosis ...Low BMD
does not equal bone loss
using BMD to predict fracture risk is important because BMD is correlated with
bone strength and BMD is predictive of future fractures in epidemiologic
studies
what cells are responsible for bone modeling and remodeling? Answer -
osteoclasts
osteoblasts
osteocytes
, define osteoclasts Answer - cells that remove ('c' CHOMP) old bone
define osteoblasts Answer - cells that build ('b' BUILD) new bone
define osteocytes Answer - cells derived from osteoblasts that are mature
bone cells thought to be regulators of remodeling
what is the bone remodeling cycle Answer - coordinated sequence of
activation, resorption, and formation
when does bone loss occur? Answer - when resorption exceeds formation
when is peak bone mass reached? Answer - it is reached when the growth in
the size of bones and accumulation of bone mineral has stabilized
different skeletal sites reach maturity at different times: trochanter, mid-teens;
femoral neck, late teens; spine, early 20s.
dramatic increase in BMD during adolescence
peak reached in teens or early twenties
overall, age 30
what is the composition of bone? Answer - bone matrix is 90% collagen and
10% other proteins
cortical bone makes up the shafts of long bones and the outer envelope of all
bones (appendicular skeleton) - makes up 80% of the skeleton, 20% of surface
area
cancellous or trabecular bone makes up the inner parts of the bones (axial
skeleton) - accounts for 20% of skeleton, but 80% of surface area
COMPLETE SOLUTIONS.
state the definition of osteoporosis Answer - NEWEST DEFINITION:
"osteoporosis is a skeletal disorder characterized by compromised bone
strength predisposing to an increase risk of fracture. bone strength reflects the
integration of two main features: bone density and bone quality"
Osteoporosis can also be defined based on the presence or history of a low-
trauma or fragility fracture
-2.5 T score or below
what is a fragility/low trauma fracture Answer - a fracture resulting from the
force of a fall from a standing height or less; or a bone that breaks under the
conditions that would not cause a normal bone to break
summarize the pathophysiology of osteoporosis Answer - bone loss occurs
when resorption exceeds formation - this can happen due to a number of
things; age related bone loss, disease related to bone loss (ex: malabsorption
diseases like certain cancers), menopause, lifestyle, etc. as bone loss occurs,
there is loss of quality as well as quantity. WHO classifies osteoporosis as -2.5
or below T-score.
what is the definition of prevalence Answer - frequency of disease at a specific
point in time ("30% of women over age 50 have osteoporosis")
,what is the definition of incidence Answer - new cases of disease over a
specific period of time ("the incidence of hip fractures in an elderly population
is 12 per 1000 person-years")
explain the prevalence and incidence of osteoporosis and fractures Answer -
prevalence of osteoporosis: estimated 200 million people have osteoporosis
worldwide
incidence of osteoporosis: hip fracture projected to increase 240% in women
and 320% in men by 2050
in women, the incidence of clinical vertebral fractures begins to increase
around age 55-60 and rises linearly (5-10 yrs later for men)
in women, the incidence of hip fractures begins to raise about age 65 and
increases exponentially (5-10 yrs later for men)
distal forearm fractures - mortality and morbidity Answer - third most
common osteoporotic fracture
risk increases early in women (age 45-50) and levels off 60-65
most likely caused by fall on outstretched hand
vertebral fracture - mortality and morbidity Answer - VERTEBRAL FRACTURE IS
THE MOST COMMON OSTEOPOROTIC FRACTURE
types: wedge, biconcave, or crush
many occur with everyday activities (lifting, pushing, pulling)
after vertebral fracture, there is a gradual increase in mortality
five-year excess mortality is increased by about 20%
hip fractures - mortality and morbidity Answer - 2nd most common
osteoporotic fracture
,most caused by fall from standing height
24-30% excess mortality within 1 year
five-year excess mortality is increased by about 20%
list the economic costs of osteoporosis and compare with other diseases
Answer - distribution of health care dollars for osteoporosis amount to about
52% for hospitalization, 30% for nursing home care and 13% for outpatient care
osteopenia (low bone density) and osteoporosis: 44 mil
hypercholesterolemia: 98.6 mil
hypertension: 73.5 mil
diabetes: 23.6 mil
explain the value of bone densitometry for diagnosis, fracture risk estimation
and monitoring Answer - for diagnosis of osteoporosis, bone densitometry
allows diagnosis of osteoporosis in asymptomatic individuals prior to fracture
using the WHO classification (-2.5 t score or below)
CAVEATS- some patients with -2.5 or below do not have osteoporosis, while
some patients with above -2.5 may be diagnosed with osteoporosis ...Low BMD
does not equal bone loss
using BMD to predict fracture risk is important because BMD is correlated with
bone strength and BMD is predictive of future fractures in epidemiologic
studies
what cells are responsible for bone modeling and remodeling? Answer -
osteoclasts
osteoblasts
osteocytes
, define osteoclasts Answer - cells that remove ('c' CHOMP) old bone
define osteoblasts Answer - cells that build ('b' BUILD) new bone
define osteocytes Answer - cells derived from osteoblasts that are mature
bone cells thought to be regulators of remodeling
what is the bone remodeling cycle Answer - coordinated sequence of
activation, resorption, and formation
when does bone loss occur? Answer - when resorption exceeds formation
when is peak bone mass reached? Answer - it is reached when the growth in
the size of bones and accumulation of bone mineral has stabilized
different skeletal sites reach maturity at different times: trochanter, mid-teens;
femoral neck, late teens; spine, early 20s.
dramatic increase in BMD during adolescence
peak reached in teens or early twenties
overall, age 30
what is the composition of bone? Answer - bone matrix is 90% collagen and
10% other proteins
cortical bone makes up the shafts of long bones and the outer envelope of all
bones (appendicular skeleton) - makes up 80% of the skeleton, 20% of surface
area
cancellous or trabecular bone makes up the inner parts of the bones (axial
skeleton) - accounts for 20% of skeleton, but 80% of surface area
