General gynae / menopause

Question 1

What is a T score?

Answer 1

Number of standard deviations by which the individuals bone marrow density differs from a 25 yo
>2.5 SD = osteoporosis

Question 2

How do you assess osteoporosis

Answer 2

DEXa scan
FRAX score

Question 3

When shoud you treat osteoporosis?

Answer 3

> 3% risk over 10 years for hip #
OR
15-20% risk of major osteoporotic fracture

Question 4

Non pharmacological ways to reduce # risk

Answer 4

Maintain BMI >20
Smoking cessation
Moderating alcohol intake
Remaining physically active
Falls prevention - removal of hazards, visual correction
Dietary intake 1000mg calcium / day

Question 5

Pharmacological interventions for osteoporosis

Answer 5

Calcium - scant evidence, with Vitamin D better
Vitamin D - regulates intestinal calcium absoprtion - supplment women not recieving regular sunlight exposure
Bisphophonates - inhibit osteoclast activity. Reduce vertebral # by >50%, hip # >40%, total fractures by 25%. Aledronate first option
Oestrogen

Only repeat DEXA scan if further fracture despite bisphosphonate use, and >1 year since starting treatment. Change treatment if BMD still low