Nutritional Metabolic and Endocrine Flashcards Preview

Radiology Tumors > Nutritional Metabolic and Endocrine > Flashcards

Flashcards in Nutritional Metabolic and Endocrine Deck (106)
Loading flashcards...
1

what is the most common metabolic bone disorder

osteoporosis

2

what is defined as skeletal disease characterized by low bone mass and micoarchitectural deterioration of bone tissue with increase in bone fragility and susceptibility to fracture

osteoporosis

3

what is osteoporosis

what bones are affected

reduction in bone quantity - decreased bone density -
normal bone just not enough of it


axial skeleton and long bones

4

what is osteopenia

poverty of bone causes increased radiolucency of bone

5

what is regional osteoporosis

what is this due to

decrease bone density in region or segment of body - limb or portion of limb

immobilization after fracture

complex regional pain syndrome - reflex sympathetic dystrophy

6

transient osteoporosis of the hip is seen on what imaging

bone scan - hot

T1 - diffuse zone of low signal intensity - edema

T2- high signal - edema

7

what is localized osteoporosis

causes

focal loss of bone density affecting a small area of bone

inflammatory arthropathy
neoplasm
infection

8

what is senescent osteoporosis

senile or old age osteoporosis

9

what does bone mass start decreases

what percent is lost per year? cortical and trabecular

what percent is lost by age 65

at menopause, bone loss accelerates to what fold? what percent per year

>35 years old

1% of bone mass lost per year of cortical bone

2% of bone mass lost per year of trabecular bone

20-40% of bone mass lost by age 65

menopause - 10 fold increase - 20 fold increase in lumbar spine - 6% lost per year


10

reduction in skeletal mass is gradual and is clinically evident in the __ decades of females life and __ decades of males

females - 5th and 6th decade

males - 6th and 7th decade

11

are men or women more affected by osteoporosis

at what age is the ratio equal

women MC 4:1

age 80 M=F

12

what are the risk factors and things than prevent osteoporosis

stay active and get exercise
eat protein, calcium, vitamin c
dont drink excessively
take estrogen after menopause
vitamin d

13

what are complications of osteoporosis

spinal cord compression fractures
increase thoracic kyphosis
fractures - femur, ribs, humerus, radius

14

incidence of __ fracture __ every __ years after the age of __ with osteoporosis

hip fracture
doubles
5 years
age 60

15

what are complications of bisphosphonates

example of drug

subtrochanteric femoral fracture - atypical stress fractures in femur diaphysis

alendronate
fosamax
actonel

16

what is the swedish study

2009 swedish study

study performed by Aspberger

incidence of mid femur stress fracture is 50x higher for patients on bisphosphonates

17

if osteoporotic patient presents with pain on coughing sneezing and straining what should you consider

acute compression fracture

18

progressive angular kyphotic deformity within a year of spinal compression fracture results in what

spinal stenosis

19

neurological abnormalities are __ with spinal compression fractures

infrequent

20

what is (percutaneous) vertebroplasty

results

complications

polymethylmethacrylate PMMA (acrylic bone cement) is injected into vertebral body to stabilize and strengthen collapsed vertebrae - outpatient

immediate and substantial results in perception of pain and function - strengthen and stabilize vertebrae

may have nerve root pain from leakage of injected material

21

20% of patients with osteoporosis compression fracture will experience what within 1 year

another fracture

22

what uses a balloon dilatation of vertebral body with subsequent instillation of polymethylmethacrylate

kyphoplasty

emphasis on balloon

23

what is a kyphoplasty procedure like

surgeon inserts catheter into vertebrae and then inserts and inflates a small balloon - this creates a cavity as it inflates - balloon is deflated and withdrawn from vertebrae - surgeon inserts needle into catheter to deliver cement into cavity - cement hardens and provides immediate stability

24

in weight bearing joints, preferential resorption of non essential supporting trabeculae occurs during bone loss with sparing of the most important trabeculae that are oriented ___

vertically - most important - they are spared in osteoporosis

25

what are some features of single photon absorptiometry

- high false negative rates - unreliable
- 2-5 mRad
- single photon emitted that is attentuated through bone - calcaneus or radius
- equal degree of association with vertebral osteoporosis

26

what are some features of dual photon absorptiometry

- photons emitted at 2 different levels
- applied to spine and proximal femur
- influenced by osteophytes, scoliosis, vascular calcifications, sclerosis
- 5-15 mRad
- low radiation dose to the patient
- high resolution images have been useful for evaluating vertebral fractures

ALSO CALLED DEXA!
dual energy xray absorptiometry

27

DEXA scores are reported as what

and what do these scores mean

T score and Z score

T score - comparison of bone density with that of a 30 year old of the same sex

Z score - comparison of bone density with that of an average person of same age and sex

28

what do the T scores of a DEXA scan indicate

T score
> -1 = normal
-1 to -2.5 = osteopenia
< -2.5 = osteoporosis

29

what do the Z scores of a DEXA scan indicate

< -2 = may indicate something other than the aging process is causing abnormal bone loss

30

what is a quantitative CT scan

MC used to assess the strength of vertebrae in assessment of fracture

measurements correlate with prevalence of fracture

200-250 mRAD!! alot of radiation

calibration with standard, dual photon beam passes through vertebral body, then compared to patient density with phantom density