Elderly

Question 1

What is the difference between osteomalacia and osteopenia?

Answer 1

Osteomalacia: inadequate mineralisation causing soft bones

Osteopenia: decreased mineral density - outcome of osteomalacia (what’s seen on a scan)

Question 2

How does vitamin D increase calcium absorption?

Answer 2

it increases calcium absorption pathways in the intestine

Also works in the kidney

Question 3

What is a T score on a DEXA scan?

Answer 3

-1.0- -2.5: osteopenia
<-2.5: osteoporosis

Calculates the difference between your bone mineral density and that of the healthy young adults

Question 4

What are the major side effects of bisphosphonates?

Answer 4

Oesophagitis
Necrosis of the jaw

Question 5

Which medications are used to treat osteoporosis?

Answer 5

Bisphosphonates
Raloxifene (SERM)
Terparatide
Denosumab (Rank-L)

Question 6

Why do you wait 2 weeks after a fragility fracture to prescribe bisphosphonates?

Answer 6

Because it can impact bone healing if given too early