General info

Question 1

Risk factors

Answer 1

SMELLL65+
Low body weight
65+
Smoker
Lack of exercise
Excess alcohol
FH of osteoporosis
Menopause (esp if early)
Long-term oral corticosteroid use
Low calcium

Question 2

How to prevent osteoporosis

Answer 2

• Maintain adequate calcium + vitamin D intake
• Correct any deficiency with supplements or diet

Question 3

Corticosteroid steroid + osteoporosis

Answer 3

Oral corticosteroid > 3 months.
1st line = bisphosphonates
Other = Calcitrol (unlicensed), HRT in women, testosterone in men (unlicensed)

Question 4

Prophylaxis of osteoporosis (post-menopausal)

Answer 4

1. Bisphosphonates
   - 1st = alendronic acid
   - 2nd = risendronate
2. Strontium ranelate
   - If bisphosphonates cant be given
3. HRT
   - If other theapies cannot be given
   - CSM: Not first line in over 50
   - Raloxifene not recommended

Question 5

Treatment of osteoporosis (post-menopausal)

Answer 5

1. Bisphosphonates
   - 1st = alendronic acid
   - 2nd = risendronate
2. Strontium ranelate/raloxifene
   - If bisphosphonates cant be given
3. Teriparatide
   - PTH
   - If bisphosphonates and strontium ranelate cant be given.