Metabolic Bone Disease Flashcards
What is osteoporosis?
Reduction in the density of bones
Most common metabolic bone disease
What is the consequence of osteoporosis?
Enhanced bone fragility and more prone to fractures
What are the risk factors for osteoporosis?
Old age
Female
Reduced mobility and activity
Low BMI
RA
Alcohol and smoking
Long term steroids
SSRIs, PPIs, anti-oestrogens
What is a key group to consider in osteoporosis?
Post- menopausal women
Oestrogen is protective against osteoporosis
Postmenopausal women have less oestrogen
What is FRAX tool?
Prediction of the risk of a fragility fracture over the next 10 years
What are the components of FRAX?
Age
BMI
Comorbidities
Smoking
Alcohol
FH
What is a DEXA scan?
Dual- energy X ray absorptiometry
Measure bone mineral density (BMD)
What is the first step in assessing osteoporosis?
Perform a FRAX assessment on at risk patients
What lifestyle changes are used for osteoporosis management?
Activity and exercise
Maintain a healthy weight
Adequate calcium intake
Adequate vitamin D
Avoiding falls
Stop smoking
Reduce alcohol consumption
What medical options are used for osteoporosis?
Vitamin D and Calcium
Bisphosphonates
Denosumab
Raloxifene
HRT
Describe bisphosphonates
First line treatment
Interfere with osteoclasts preventing bone resorption
Describe bisphosphonates
First line treatment
Interfere with osteoclasts preventing bone resorption
E.g. Alendronate
What are the side effects of bisphosphonates?
Reflux and oesophageal erosions
Atypical fractures
Osteonecrosis of the jaw
Osteonecrosis of the external auditory canal
Describe denosumab
Monoclonal antibody that blocks osteoclast activity
Describe raloxifene
Selective oestrogen receptor modulator- stimulates oestrogen receptors on bone
Secondary prevention only