Elderly Care - CAPSULE

Question 1

A 74-year-old woman who lives in a residential home falls and fractures her right wrist. You see her in your dedicated falls and bone health clinic.
You would like to know the state of her bones. What kind of tests would you organise for this patient? (2)
A) Bone Scan
B) DEXA Scan
C) Calcium and Vitamin D
D) Parathyroid hormone levels
E) Bone turnover markers

Answer 1

B) DEXA Scan

C) Calcium and Vitamin D

Question 2

In women aged under 75 a … Scan is indicated along with Calcium and Vitamin D blood tests to assess for deficiency. In women over 75 a presumptive diagnosis of … is made. Bone turnover markers are only used with non-compliance with treatment is suspected, ie. very rarely.

Answer 2

In women aged under 75 a DEXA Scan is indicated along with Calcium and Vitamin D blood tests to assess for deficiency. In women over 75 a presumptive diagnosis of Osteoporosis is made. Bone turnover markers are only used with non-compliance with treatment is suspected, ie. very rarely.

Question 3

What is the cut off T-score for osteoporosis?

Answer 3

-2.5

Question 4

A T-score of -2.5 and below confirms … and is diagnostic.

Answer 4

A T-score of -2.5 and below confirms osteoporosis and is diagnostic.

Question 5

If she had a bone mineral density suggestive of severe osteoporosis, not just explained by being post menopausal, what other tests might you order?

Answer 5

Thyroid function tests
Calcium
PTH
Vitamin D levels
Bone turnover markers