ENDOCRINE - BONE DISORDERS Flashcards
What is osteoporosis?
Low bone mineral density + risk of fractures.
What are other risk factors for osteoporosis?
Elderly, hx of hip fractures
Low BMI, smoking , excess alcohol, diabetes, vit d + calcium deficiency, early menopause
What are 3 main risk factors for osteoporosis?
Menopause
50+ in men
Long term glucocorticoid
What is 1st line treatment for osteoporosis?
Oral bisphosphonates
e.g. alendronic acid + Risedronate
How to prevent osteoporosis?
Avoid Long term glucocorticoids
What dose of steroid is likely to give high risk of osteoporosis?
7.5mg or more daily prednisolone
What 3 situations should prophylactic bisphosphonate tx start for gluccocorticoid treatment in women?
If 70 or +
OR
Previous fracture
OR
Large dose steroid 7.5mg pred or more (>3 months)
What 3 situations should prophylactic bisphosphonate tx start for gluccocorticoid treatment in men?
70 and over AND either:
previous fracture
large doses steroid (>3 months)
What do menopause women go on to reduce risk. of osteoporosis?
HRT - if they are more than 60+ and have menopause symtpoms
What is calcitriol?
synthetic Vit d3
What are 3 examples of HRT which can reduce risk of osteopororis?
Oestrogens
Tibolone
Raloxifene
What is a risk of using strontium ranelate?
CV events, reports of severe allergy
MOA of bisphosphonates?
Slows bone resorption by adsorbing onto hydroxyapatite crystals.
How long is treatment with bisphosphonates?
5 years
What bisphosphonate has the highest risk of jaw osteonecrosis?
Zolendronic acid