Osteoporosis Flashcards
Definition of Osteoporosis
A metabolic bone disease characterised by low bone mass and micro architectural deterioration of bone tissue, leading to enhanced bone fragility and a consequent increase in fracture risk
Relevance of Osteoporosis is
risk of fracture
Risk of fracture related to what in osteoporosis
Age
BMD
Falls
Bone Turnover
Fracture risk assessment tools indicate whether someone is at risk of
Osteoporosis
If person is defined as >10% risk of osteoporotic fracture over 10 years patient should be referred for
DXA Scan
Who should be referred for DXA scan regardless of fracture risk percentage
Patients on Steroids or Low Trauma Fracture
Over 50 particularly at risk of
Osteoporosis
Endocrine causes of Osteoporosis (6)
Thryotoxicosis Hyperparathyrodism Hypoparathyrodism Cushings Hyperprolactinaemia Hypopituitarism
Rheumatic Causes of Osteoporosis (3)
Rheumatoid Arthritis
Ankylosing Spondylitis
Polymyalgia Rheumatica
GI Causes of osteoporosis (9)
IBD Alcoholic Cirrhosis Viral Cirrhosis Cystic Fibrosis Chronic Pancreatitis Coeliac Disease Whipples Short gut Syndrome Ischaemic Bowel
Medications which cause Osteoporosis (6)
Steroids PPI Enzyme Inducting Antiepileptic Medications Aromatase Inhibitors GnRH inhibitors Warfarin
Accelerated loss of bone mass begins when
Menopause
All over 50s who have suffered low trauma fracture should have
DXA Bone Scan
How to prevent osteoporotic fractures
Minimise risk factors
Ensure good calcium and vitamin D status
falls prevention strategies
medications
What medication helps manage osteoporotic fracture prevention
HRT
Side effects of HRT to prevent Osteoporotic Fractures
Increased risk blood clots
Increased risk of breast cancer
Increased risk of heart disease
Which medication helps manage osteoporotic fracture prevention in vertebrae
raloxifene - selective osteogren receptor modulator
negative effects of selective osteogren receptor modulator
hot flushes
increased clot
lack of protection at hip
What is generally first line of treatment for osteoporosis
Oral Bisphosphonates
What is required for oral bisphosphonates for osteoporosis
Adequate Renal Function required
Acquired Calcium and Vit D Status
Who should you notify if taking Oral biphosphonates for osteoporosis
Dentist
Side effects of bisphosphonates
Osteophagitis
Uveitis
Not safe when eGFR <30
Atypical Femoral Shaft Fracture
After 10 years of being on Oral Bisphosphonates what should you do
Drug holiday for 1-2 years
What does Denosumab do in Osteoporosis
Monoclonal Antibody against RANKL
Reduces Osteoclastic Bone resorption
Subcut injection every 6 months
