Osteoporosis Flashcards

1
Q

Definition of Osteoporosis

A

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

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2
Q

Relevance of Osteoporosis is

A

risk of fracture

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3
Q

Risk of fracture related to what in osteoporosis

A

Age
BMD
Falls
Bone Turnover

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4
Q

Fracture risk assessment tools indicate whether someone is at risk of

A

Osteoporosis

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5
Q

If person is defined as >10% risk of osteoporotic fracture over 10 years patient should be referred for

A

DXA Scan

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6
Q

Who should be referred for DXA scan regardless of fracture risk percentage

A

Patients on Steroids or Low Trauma Fracture

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7
Q

Over 50 particularly at risk of

A

Osteoporosis

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8
Q

Endocrine causes of Osteoporosis (6)

A
Thryotoxicosis
Hyperparathyrodism
Hypoparathyrodism
Cushings
Hyperprolactinaemia
Hypopituitarism
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9
Q

Rheumatic Causes of Osteoporosis (3)

A

Rheumatoid Arthritis
Ankylosing Spondylitis
Polymyalgia Rheumatica

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10
Q

GI Causes of osteoporosis (9)

A
IBD
Alcoholic Cirrhosis
Viral Cirrhosis 
Cystic Fibrosis 
Chronic Pancreatitis 
Coeliac Disease
Whipples
Short gut Syndrome
Ischaemic Bowel
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11
Q

Medications which cause Osteoporosis (6)

A
Steroids
PPI
Enzyme Inducting Antiepileptic Medications
Aromatase Inhibitors
GnRH inhibitors
Warfarin
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12
Q

Accelerated loss of bone mass begins when

A

Menopause

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13
Q

All over 50s who have suffered low trauma fracture should have

A

DXA Bone Scan

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14
Q

How to prevent osteoporotic fractures

A

Minimise risk factors
Ensure good calcium and vitamin D status
falls prevention strategies
medications

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15
Q

What medication helps manage osteoporotic fracture prevention

A

HRT

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16
Q

Side effects of HRT to prevent Osteoporotic Fractures

A

Increased risk blood clots
Increased risk of breast cancer
Increased risk of heart disease

17
Q

Which medication helps manage osteoporotic fracture prevention in vertebrae

A

raloxifene - selective osteogren receptor modulator

18
Q

negative effects of selective osteogren receptor modulator

A

hot flushes
increased clot
lack of protection at hip

19
Q

What is generally first line of treatment for osteoporosis

A

Oral Bisphosphonates

20
Q

What is required for oral bisphosphonates for osteoporosis

A

Adequate Renal Function required

Acquired Calcium and Vit D Status

21
Q

Who should you notify if taking Oral biphosphonates for osteoporosis

A

Dentist

22
Q

Side effects of bisphosphonates

A

Osteophagitis
Uveitis
Not safe when eGFR <30
Atypical Femoral Shaft Fracture

23
Q

After 10 years of being on Oral Bisphosphonates what should you do

A

Drug holiday for 1-2 years

24
Q

What does Denosumab do in Osteoporosis

A

Monoclonal Antibody against RANKL
Reduces Osteoclastic Bone resorption
Subcut injection every 6 months

25
Q

What is safer for patients with renal impairment in osteoporosis

A

Denosumab

26
Q

Side effects of Denosumab

A

Allergy

Symptomatic Hypocalcaemia if given when Vit D deplete