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MSK > 18 - Osteoporosis > Flashcards

18 - Osteoporosis Flashcards

1
Q

define osteoporosis?

A

metabolic bone disease characterised by low bone mass and micro architectural deterioration of bone tissue, leading to enhanced bone fragility and a consequent increase in fracture risk

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2
Q

what is the major risk associated with osteoporosis?

A

fracture risk

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3
Q

what tool can be used to calculate fracture risk?

A

FRAX questionnaire

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4
Q

who is the Q fracture applicable to?

A

those aged 30-85, men and women

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5
Q

name 3 variables in the Q fracture?

A

cardiovascular risk, falls, tricyclic antidepressants

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6
Q

what scanner can be used?

A

Prodigy scanner/ DXA scans

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7
Q

what are fracture risk assessment tools used to assess?

A

whether someone is at risk of osteoporosis/ not

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8
Q

when is the risk considered significant?

A

> 10% risk of osteoporotic fracture over 10 years

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9
Q

who should always be sent for a DXA scan regardless of their fracture risk %?

A

those on oral steroids/ suffer a low trauma fracture

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10
Q

how many women > 50 years will have osteoporotic fracture before they die?

A

1/2

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11
Q

how many men > 50 years will have osteoporotic fracture before they die?

A

1/5

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12
Q

M:F?

A

F>M

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13
Q

name 4 endocrine causes of osteoporosis?

A

Thyrotoxicosis, Hyper/Hypo-parathyroidim,

Cushings, Hyperprolactinaemia

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14
Q

name 4 rheumatic causes of osteoporosis?

A

Rheumatoid arthritis

Ankylosing Spondylitis

Polymyalgia Rheumatica

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15
Q

name 2 Inflammatory GI causes of osteoporosis?

A

UC and Crohn’s

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16
Q

name 4 liver causes of osteoporosis?

A

1y biliary cholangitis, chronic active hepatitis, alcoholic cirrhosis, Hep C

17
Q

name 4 malabsorption causes of osteoporosis?

A

Cystic Fibrosis, chronic pancreatitis, coeliac disease, whipples disease

18
Q

name 4 medications which cause osteoporosis?

A

steroids, PPI, aromatase inhibitors, warfarin

19
Q

when is our peak bone mass?

A

~ 30 years old

20
Q

when does accelerated loss of bone mass occur in women?

A

menopause

21
Q

what is the risk for those who have already had a fracture?

A

increased - should be offered a DXA bone scan

22
Q

4 ways in which we can help prevent fractures?

A

Minimise risk factors, Ensure good calcium and Vitamin D status, Falls prevention strategies, Medications

23
Q

which medication can be used to decrease the likelihood of fractures?

A

HRT

24
Q

3 increased risks associated with HRT?

A

blood clots, breast cancer, heart disease (stroke)

25
Q

what type of drug is raloxifene?

A

selective oestrogen receptor modulator (SERM)

26
Q

3 disadvantages to SERMs?

A

hot flushes, increased clot risks, lack of protection at the hip

27
Q

first line of treatment for osteoporosis?

A

oral bisphosphonates

28
Q

3 things which a patient must have to have oral bisphosphonates as 1st line treatment for osteoporosis?

A

good/adequate -

renal function, calcium and vitamin D status, dental health

29
Q

name 2 side effects of Bisphosphonates?

A

oesophagitis, iritis

30
Q

what type of drug is denosumab?

A

monoclonal antibody

31
Q

what is the role of denosumab?

A

reduces osteoclastic bone resorption

32
Q

how is denosumab administered and how often?

A

subcutaneous injection every 6 months

33
Q

what should patients with renal impairment be given as 1st line?

A

denosumab

34
Q

name 2 side effects of denosumab?

A

allergy/ rash, symptomatic hypocalacaemia

35
Q

which intermittent human parathyroid hormone can be used to improve patients’ risk?

A

teriparatide

36
Q

name 2 side effects of teriparatide?

A

injection site irritation, allergy

MSK (26 decks)

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