Osteoperosis

Question 1

what defines osteoperosis

Answer 1

T

Question 2

what defines osteopenia

Answer 2

T between -1 to -2.5

Question 3

Screening guideline for osteoperosis

Answer 3

Women > 65

• early if increased risk
• FRAX tool or ORAI tool (age, weight, estrogen therapy)

Question 4

If prior fx, screening?

Answer 4

No, direct to Rx

Question 5

What defines as “increased risk” in screening osteoperosis?

Answer 5

10-year risk greater than 9.3% (FRAX)

Question 6

LifeStyle Managment for osteoperosis

Answer 6

• weight bearing exercise and strength training

- smoking cessation and avoid excess alcohol

Question 7

Vitamin D for osteoperosis

Answer 7

• If level normal (>30), 800-1000 IU
• if level insufficient (20-30), 1000 IU
• If level deficient (

Question 8

Ca for osteoperosis

Answer 8

1200 mg/day

Question 9

Who should receive medications (other than vitamin D/Ca) Rx for osteoperosis

Answer 9

• All genders with hx of non-traumatic hip of vertebral fx
• Osteoperosis
• Osteopenia + High Risk (> 3% in 10 yrs, > 20% of other fx)
• Chronic steroids (> 5 mg for 3 months)
• Men with prostate Ca on antiandrogen with high risk

Question 10

What’s the first line for osteoperosis Rx

Answer 10

Bisphophanates

• 3-5 years treatemtn course
• if taken po, needs to drink lots of water and stay upright for 1-2 hours (esophagitis)
• decrease risk of vert and hip fx

Question 11

Examples of Bisphophanates

Answer 11

Alendronate: po daily or weekly
Risedronate: po daily, wkly or monthly
Ibandronate: po daily or monthly, IV q3mo
Zoledronic acid: IV yearly for 2 years

Question 12

Other Rx for osteophrosis (non first-line)

Answer 12

Raloxifen(SERM) - dec risk of breast ca, dec risk of vert fx
Calcitonin: analgesic effect, only prev vertebral
Teri[aratide: if high risk and fx on bispho