0625 - Osteoporosis

Question 1

What are the major risk factors for osteoporosis?

Answer 1

Female sex (2:1)
Age (particularly post-menopause)
Postmenopause
RA
Environmental - Ca deficiency, EtOH, Drugs, Smoking
Endocrine - hyperparathyroidism, Cushing’s

Question 2

What is osteoporosis?

Answer 2

Fragility of bone causing increased risk of fracture. Generally considered as BMD T score below -2.5.

Question 3

What is the difference between osteoporosis and osteomalacia?

Answer 3

Osteopenia/osteoporosis - Bone matrix is normally mineralised, but there is less bone.
Osteomalacia - Insufficient Ca/Pi to mineralise osteoid - bone is softer, liable to bend, deform, or fracture.

Question 4

What are the types of osteoporosis?

Answer 4

Generalised - primary or secondary

Regional - transient, either regional, hip, or migratory.

Question 5

How is osteoporosis diagnosed?

What are the porosis/penia T-scores?

Answer 5

Bone mineral density, usually by DEXA scan. This is used to calculate a T-score and a Z score.
Osteoporosis is T score below -2.5. Osteopenia -1 to -2.5.

Question 6

What is a T-score and a Z-score in osteoporosis?

Answer 6

T-score - number of standard deviations above or below the mean BMD in a young, healthy population.
Z-score - number of standard deviations above or below an age, sex, and race-matched population.

Question 7

How is osteoporosis managed?

Answer 7

Attain best possible peak bone density.
Non-pharmacological - exercise, calcium, vitamin D, and risk factor avoidance.
Pharmacological - Antiresorptives, Anabolic agents, dual agents.