History taking for OP Flashcards
What is the greatest RF for OP?
Increasing age
- affects 30% of post-menopausal women
Important risk factors to be explored in history:
SEW FAD
S: Sun exposure (low?)
E: Early menopause
W: Weight bearing exercise (low)
F: Frequent falls
A: Alcohol/smoking (xcessive?)
D: Diet (inadequate calcium)
After going through potential risk factors, can you continue with your assessment for OP?
No
- should look for potential 2˚ causes of OP
- ex. genetic pre-disposition, inflammatory disease states
Endocrine diseases to rule out as 2˚ cause of OP
Hyperthyroidism, hyperparathyroidism, Cushing’s syndrome, hypogonadism (especially important in men)
GI diseases to rule out as 2˚ cause of OP
Celiac disease, Crohn’s or ulcerative colitis, gastric bypass
(malabsorption)
Malnutrition issues to rule out as 2˚ cause of OP
anorexia nervosa, alcoholism
Medications to rule out as 2˚ cause of OP
corticosteroids, phenytoin, long term heparin therapy
Bone marrow disorders issues to rule out as 2˚ cause of OP
multiple myeloma, leukaemia
Clinical presentations suggestive of the presence of osteoporosis
- minimal trauma fractures (fracture from a slip, trip or fall from standing height or less)
- Colles fracture (distal radius)
- Fractured neck of femur
- Rib fractures with coughing
- Vertebral compression fracture
- Height loss with ageing (due to thoracic vertebral crush fractures
Relevant social & medication Hx (overview)
- Habits
- Diet
- Daily activities and exercise (esp. weight-bearing)
- Medications for osteoporosis
Relevant social & medication Hx - habits
cigarettes, alcohol, and drug use
Relevant social & medication Hx - diet
dietary intake of calcium (need 3 serves/day)
Relevant social & medication Hx - medications for OP
- calcium / vit. D supplements
- anti-resorptive therapy (bisphosphonates / denosumab)
- HRT
