Bone Clinic

Question 1

How do you define osteoporosis vs osteopenia

Answer 1

Osteoporosis = low bone density, T score less than -2.5
Osteopenia = -1 to -2.5

Question 2

T score vs Z score and when are they used

Answer 2

T score is the bone mineral density of a middle aged woman whereas Z score is the bone mineral density of someone with similar age, ethnicity, gender etc

T score used in post menopausal women, Z score in premenopausal women as you want to compare their BMD with someone of a similar age (e.g. if they’re 20 you don’t want to use a T score from someone who is 35).

Question 3

Give a cause of osteoporosis in a young person

Answer 3

Anorexia
Cushings

Question 4

What is something to be careful about on a bone scan. How do you read it.

Answer 4

The whiter the bone, the more dense, however arthritis can also show up white and therefore it can be inaccurate.

Question 5

What do you call a ball and screw hip replacement

Answer 5

Hip arthroplasty

Question 6

How do bisphosphonates work?

Answer 6

Anti osteoclastic activity
Anti osteoblast activity (less so)

Question 7

How often do you take zolendronic acid

Answer 7

Yearly infusion, up to 6 years with a drug holiday

Question 8

Why do patients need a drug holiday?

Answer 8

To allow the bone to recover, as otherwise the micro fractures in teeth and long bones will accumulate and cause a fracture