8: Osteoporosis

Question 1

Name modifiable risk factors for osteoporosis.

Answer 1

1. Excessive thinness (BMI <21)
2. Hypogonadal states (anorexia, athletic amenorrhea, premature menopause, hyperprolactinemia, Turner’s and Klinefelter’s syndromes)
3. Nulliparity
4. Lifestyle (smoking, alcohol, caffeine, sedentary, frequent falls, inadequate Ca and Vit D)
5. Medications
6. Chronic diseases (endocrine, GI, bone, liver, seizures, immobility, eating disorders, chronic renal failure, frailty)

Question 2

Which meds can cause osteoporosis?

Answer 2

1. Thyroid hormone
2. Corticosteroids
3. Anticonvulsants
4. Aluminum containing antacids
5. Lithium
6. Methotrexate
7. GnRH
8. Cholestyramine
9. Heparin
10. Depo
11. Premenopausal Tamoxifen
12. SSRIs
13. PPIs

Question 3

Name nonmodifiable risk factors of osteoporosis.

Answer 3

1. Advanced age
2. Female
3. Race (esp Caucasian)
4. Hx of fracture in adulthood
5. Fm hx of osteoporosis
6. 1st degree relative with hx of fracture
7. Genetic disease
8. Hemotologic disorders
9. Rheumatologic and autoimmune disease

Question 4

Name some genetic disorders that increase risk for osteoporosis.

Answer 4

1. Cystic fibrosis
2. Ehlers-Danlos
3. Osteogenesis imperfecta
4. Porphyria
5. Gaucher’s disease
6. Hemochromatosis
7. Marfan syndrome
8. Homocystinuria

Question 5

Name some hematologic disorders that increase risk for osteoporosis.

Answer 5

1. Hemophilia
2. Sickle cell
3. Multiple myeoloma
4. Thalassemia
5. Leukemia
6. Lymphomas

Question 6

Name some rheumatologic and autoimmune diseases that increase risk for osteoporosis.

Answer 6

1. SLE
2. Rheumatoid arthritis
3. Ankylosing spondylitis

Question 7

What strategies help prevent osteoporosis?

Answer 7

1. 1200 mg/day Ca
2. 800-1000 IUs/day Vit D
3. Weight-bearing and resistance exercises
4. Fall prevention
5. Avoiding tobacco
6. <2 alcoholic drinks/day (for women)