15: Osteoporosis- Thompson Flashcards
risk factors
white and asian female lower weight age genetics
falls a ____ risk than low BMD
bigger risk
Who needs treatment?
- postmenopausal with hip fx
- tscore greater than -2.5
- tscore -1 to -2.5 and 10 yr probability of hip fracture 3% or risk of any major fracture 20%
Who needs testing?
USPSTF recommendations
- all women 65 and older
- women under 65 whose 10 yr risk factor of fracture is equal to or greater than a 65 yo
primary type I osteoporosis =
post menopausal women
- less bone stock, smaller frames, menopause, live longer
primary type II osteoporosis =
those over 70 yo
primary v secondary osteoporosis
2nd = hypogonadal (early menopause/late menarche, androgen insensitivity, over-training in females)
30% women/ 50% men are secondary if Vit D deficiency is considered 2nd cause
secondary causes of osteoporosis
smoking
ETOH
sedentary lifestyle
diet
why are steroids a secondary cause of osteoporosis?
long term use–> decrease formation of new bone, increase breakdown
Sz meds, SSRI, depo shots also increase risk
calcium, vit D and magnesium deficiencies …
secondary causes of osteoporosis
DEXA =
dual energy xray absorptiometry
measure BMD in hip and in spine
T score v. Z score
t score compares to same sex healthy 30 yo
z score compares to someone same age, sex, etc.
Tscores
normal
osteopenia
osteoporosis
0 to -1
-1 to -2.5
less than -2.5
t score alone less risk than t score and adverse risk factors
first line treatment
bisphosphonates
prevention/treatment with caclium and vit D
1200 mg Ca daily beginning age 35
vitamin D 800 U daily
give together!
