Block 5: Osteoporosis Flashcards
Differentiate BMD classifications?
How do you diagnose osteoporosis?
What are the risk factors for osteoporosis?
- Alcohol use(3+/day)
- Smoking
- Hypogonadism
- Prior fracture as adult/ Parental fx.
- Early menopause(b4 age 45)
- SSRI, PPI, TZD, glucocorticoids
- Chemo drugs
- Corticosteroids(>5mg pred x >3 months)
- Depo-Provera
What is FRAX?
10-year risk model for calculating fracture risk, often used to determine if treatment is warranted
What is Garvan calculator?
Uses age, sex, low trauma fracture, and falls to calculate 5-10 year risk for osteoporotic and hip fractures
Disadvantages: doesnt include falls and number of previous fractures
What are the clinical presentation of osteoporosis?
- Asymptomatic
- Pain
- Immobility-physical limitations
- Fragility
How is osteoporosis assessed based on height?
Loss from maximum height: >1.5 inches loss
Since a previously documented measurement:>0.8 inch loss
Kyphosis or lordosis
Who qualify for Central DXA screening?
Women
- All women 65 years and older
- Postmenopausal
- fragility fracture
- Discontinuing estrogen
- Risk of fractures
Who qualify for Central DXA screening?
Men
- All men older than 70 years of age
- Men ages 50-70 with risk factors or previous fractures
What is the gold standard that measures hip or lumbar spine BMD?
Dual-energy x-ray absorptiometry (DXA)
What measures volumetric BMD of lumbar spine?
Quantitative computed tomography (QCT)
What tools are not appropriate for monitoring?
Peripheral DXA (pDXA) and peripheral QCT (pQCT)
What tool is used to identify vertebral fractures becuase they are asymptomatic?
Vertebral imaging
What is DXA?
Bone density testuses X-rays to measure how many grams of calcium and other bone minerals are packed into a segment of bone
What does DXA assess?
T-score: Compared to young normal adults of same sex
Z-score: Compared to expected norms of patients age and sex