fortune world school

2022 – 2023
Biology Investigatory Project
“OSTEOPOROSIS”
NAME– JIYA SINGH
CLASS - XII-C

INDEX
1. INTRODUCTION

2. RISK FACTORS

3. SYMPTOMS

4. PATHOPHYSIOLOGY

5. DIAGNOSIS

6. Daily life problems

7. PRENVENTION and PRECAUTIONS

8. TREATMENTs

9. CASE STUDY

10. BIBLIOGRAPHY

-INTRODUCTION-
● Osteoporosis is the weakening of bones in the body. It is caused by
lack of calcium deposited in the bones. This lack of calcium causes
the bones to become brittle. They break easily.
● Osteoporosis means "porous bones." Our
bones are strongest at about age 30, and

then begin to lose density.

● Bone is living, growing tissue. It is made mostly of collagen and
protein that provides a soft framework and calcium that adds
strength and phosphate a mineral that hardens the framework.
● This combination of collagen and calcium makes bone both flexible
and strong, which in turn helps bone to withstand stress

● Osteoporosis occurs when there is

imbalance between the bone formation and
bone resorption which usually occurs in
later stages of life.
 Osteoporosis causes bones to become weak and brittle — so
brittle that a fall or even mild stresses such as bending over
or coughing can cause a fracture. Osteoporosis-related
fractures most commonly occur in the hip, wrist or spine
● Osteoporosis develops when bone density decreases. The body
reabsorbs more bone tissue and produces less to replace it.
● The most common injuries in people with osteoporosis are:

● broken wrist
 ● Broken spinal bones (vertebrae)
● Broken hip

-RISK FACTORS-
Factors that will increase the risk of developing osteoporosis are:

1. Female gender, Caucasian or Asian race, thin and small body

frames, and a family history of osteoporosis. (Having a mother
with an osteoporotic hip fracture doubles your risk of hip fracture.)

2. Cigarette smoking, excessive alcohol and caffeine consumption,

lack of exercise, and a diet low in calcium.

3. Poor nutrition and poor general health.

4. Malabsorption (nutrients are not properly absorbed from the

gastrointestinal system) from conditions such as Celiac Sprue.
5. Low estrogen levels such as occur in menopause or with early
surgical removal of both ovaries. Another cause of low estrogen
level is chemotherapy, such as for breast cancer. Chemotherapy
can cause early menopause due to its toxic effects on the ovaries.

6. Amenorrhea (loss of the menstrual period) in young women also

causes low estrogen and osteoporosis. Amenorrhea can occur in
women who undergo extremely vigorous training and in women
with very low body fat (example: anorexia nervosa).

7. Chronic diseases such as rheumatoid arthritis and chronic

hepatitis C, an infection of the liver.

8. Immobility, such as after a stroke, or from any condition that

interferes with walking.

9. Hyperthyroidism, a condition wherein too much thyroid

hormone is produced by the thyroid gland (as in Grave's disease)
or is caused by taking too much thyroid hormone medication

10. Hyperparathyroidism, a disease wherein there is excessive

parathyroid hormone production by the parathyroid gland (a small
gland located near the thyroid gland). Normally, the parathyroid
hormone maintains blood calcium levels by, in part, removing
calcium from the bone. In untreated hyperparathyroidism,
excessive parathyroid hormone causes too much calcium to be
removed from the bone, which can lead to osteoporosis.

11. Vitamin D deficiency. Vitamin D helps the body absorb

calcium. When vitamin D is lacking, the body cannot absorb
adequate amounts of calcium to prevent osteoporosis. Vitamin D
deficiency can result from lack of intestinal absorption of the
vitamin such as occurs in celiac sprue and primary biliary
cirrhosis.

12. Certain medications can cause osteoporosis. These include

heparin (a blood thinner), anti-seizure medications phenytoin
(Dilation) and Phenobarbital, and long term use of corticosteroids
(such

-SYMPTOMS-
When to visit a doctor -
Common symptoms include:
● Sudden, severe back pain

● Back pain that gets worse when standing or walking,

but gets a bit better when you lie down

● Back pain when bending or twisting

● Loss of height

● Curved or stooped shape to your spine

● Recurrent fractures

● Postmenopausal women

-PATHOPHYSIOLOGY OF -
OSTEOPOROSIS
Osteoporosis occurs when there is imbalance
between new bone formation and old bone
resumption. Two essential minerals for normal
bone formation are calcium and phosphate.

HOW IS OSTEOPOROSIS DIAGNOSED AND EVALUATED?

To diagnose osteoporosis and assess your risk of fracture

and determine your need for treatment, your doctor will
most likely order a bone density scan.
This exam is used to measure bone mineral density (BMD).
It is most commonly performed using dual energy x-ray
absorptiometry (DXA or DEXA) or bone densitometry. The
amount of x-rays absorbed by tissues and bone is measured
by the DXA machine and correlates with bone mineral
density.
The following procedures can be performed to determine
bone fractures due to osteoporosis:
1. Bone x-ray: Bone x-ray produces images of bones within
the body, including the hand, wrist, arm, elbow, shoulder,
foot, ankle, leg (shin), knee, thigh, hip, pelvis or spine. It
aids in the diagnosis of fractured bones, which are
sometimes a result of osteoporosis.
2. CT scan of the spine: CT scanning of the spine is
performed to assess for alignment and fractures. It can be
used to measure bone density and determine whether
vertebral fractures are likely to occur.
3. MRI of the spine: Magnetic resonance imaging of the
spine is performed to evaluate vertebral fractures for
evidence of underlying disease, such as cancer, and to assess
if the fracture is old or new. New fractures usually
demonstrate a better response to treatment by vertebroplasty
and kyphoplasty

DAILY LIFE PROBLEMS WITH

OSTEOPOROSIS
 In addition to making you more susceptible to breaks
and fractures, osteoporosis can lead to other
complications:

●LIMITED MOBILITY

Osteoporosis can be disabling and limit your physical activity. A

loss of activity can cause you to gain weight. It can also increase
stress on your bones, in particular your knees and hips. Gaining
weight can also increase your risk of other problems, such as heart
disease and diabetes.

● DEPRESSION

Less physical activity can lead to a loss of independence and

isolation. Activities you once enjoyed may be too painful now.
This loss, added to the possible fear of fractures, can bring on
depression. A poor emotional state can further hinder your ability
to manage health issues. A positive, forward-thinking outlook is
helpful when approaching any medical issue.

● PAIN

Fractures caused by osteoporosis can be severely painful and

debilitating. Fractures of the spine can result in:

1. A loss of height

2. A stooping posture
 3. Persistent back and neck pain

● HOSPITAL ADMISSION

Some people with osteoporosis can break a bone and not notice it.
However, most broken bones need hospital care. Surgery is often
needed for this procedure, which may require an extended hospital
stay and additional medical costs.

● NURSING HOME CARE

Many times, a hip fracture will require long-term care in a nursing

home. If a person is bedridden while receiving long-term care, there’s
a higher likelihood, they may experience:

1. Cardiovascular complications

2. More exposure to infectious diseases

3. An increased susceptibility to various other complications

-PREVENTION-
● GET THE RIGHT AMOUNT OF CALCIUM

When it comes to calcium, more is not always better. You should

strive to hit the daily intake recommendation:

1,000 mg for women 50 and younger

1,200 MG FOR WOMEN 51 AND OLDER

● DON’T FORGET VITAMIN D

Vitamin D helps your body absorb calcium and use it to strengthen

your bones. When your skin is exposed to sunlight, your liver and
kidneys are responsible for making vitamin D

Your goal should be:

600 international units (IU) of vitamin D per day if you are 70 or

younger

800 IU if you are 71 or older

● Children and adolescents should:

Ensure a nutritious diet with adequate calcium intake.

Avoid protein malnutrition and under-nutrition.

Maintain an adequate supply of vitamin D.

Participate in regular physical activity.

Avoid the effects of second-hand smoking.

● ADULTS SHOULD:

Ensure a nutritious diet and adequate calcium intake

 Avoid under-nutrition, particularly the effects of severe weight-
loss diets and eating disorders maintain an adequate supply of
vitamin D

Participate in regular weight-bearing activity

Avoid smoking and heavy drinking

-Treatment-
Treating osteoporosis involves treating and preventing
fractures, and using medicines to strengthen bones

MEDICINES FOR OSTEOPOROSIS

A number of different medicines are used to treat osteoporosis (and
sometimes osteopenia).

B ISPHOSPHONATES
Bisphosphonates slow the rate that bone is broken down in your
body. This maintains bone density and reduces your risk of a broken
bone.
There are a number of different bisphosphonates, including:

• Alendronic acid • Ibandronic acid

• Risedronic acid • Zoledronic acid

They're given as a tablet or injection.

Always take bisphosphonates on an empty stomach with a full

glass of water. Stand or sit upright for 30 minutes after taking
them. You'll also need to wait between 30 minutes and 2 hours
before eating food or drinking any other fluids.

Bisphosphonates usually take 6 to 12 months to work and you may

need to take them for 5 years or longer.

The main side effects associated with bisphosphonates include:

• Irritation to the food pipe

• swallowing problems • Stomach pain

 Selective estrogen receptor modulators

(SERMs)
SERMs are medicines that have a similar effect on bone as the
hormone estrogen. They help to maintain bone density and reduce
the risk of fracture, particularly of the spine.
Raloxifene is the only type of SERM available for treating
osteoporosis. It's taken as a daily tablet.

Side effects associated with raloxifene include:

• Hot flushes • Leg cramps

• A potential increased risk of blood clots

P ARATHYROID HORMONE
Parathyroid hormone is produced naturally in the body. It regulates
the amount of calcium in bone.

Parathyroid hormone treatments (such as teriparatide) are used to

stimulate cells that create new bone. They're given by injection.

 Calcium and vitamin D supplements

Calcium is the main mineral found in bone, and having enough
calcium as part of a healthy, balanced diet is important for
maintaining healthy bones.

Vitamin helps the body absorb calcium. All adults should have 10
micrograms of vitamin D a day.

 HRT (hormone replacement therapy)

HRT is sometimes taken by women who are going through the
menopause, as it can help control symptoms.
HRT has also been shown to keep bones strong and reduce the risk
of breaking a bone during treatment.

CASE STUDY-1
Name of the Patient - Mrs. Arpeeta Singh
Age- 65 years
Sex- Female
Name of Doctor- Dr. D.K. Gupta
Symptoms
● Pain in Right Knee
● Swelling in Rt. Knee

 Investigations
● Calcium: 8.0 mg/ (borderline)
● Vita D-3: 10.9ng/ml (Low)
● BMD 748 g/cm3 (Low)
● X-ray of RT knee joint Shows
Osteoporotic changes

 Diagnosis
● Arthritis of RT Knee
 Treatment-
 Medications
● Ultracet tab.
● D. rise sachet
● Tab celol
 Physiotherapy
● Oxalgin gel locally
 Slow walking
 Knee Exercises
 Quadriceps exercises
 Freeze Precautions Advised Avoid brisk walking
 Use Western toilet
 Exposure to sun advised
 Intake of calcium rich diet.
 Flexion knee brace to be used.