Osteoporosis Flashcards
1
Q
Drugs that cause osteoporosis
A
Steroids Chronic heparin therapy Thyroxine over replacement Lithium Phenytoin Cyclosporin Aromatise inhibitors
2
Q
Major secondary causes of Osteoporosis - GI causes
A
Malabsorption syndromes (e.g. coeliac, Crohn’s, gastric bypass) Chronic cholestasis (e.e primary Hillary cirrhosis)
3
Q
Major secondary causes of osteoporosis- malnutrition
A
Anorexia nervosa
Scurvy
Alcoholism
4
Q
Major secondary causes of osteoporosis - bone marrow disorders
A
Multiple myeloma
Disseminated carcinoma
Lymphoma
Leukaemias
5
Q
Major secondary causes of osteoporosis- Connective Tissue diseases
A
Marfan’s syndrome, Ehlers-Dando’s syndrome
Osteogenesis imperfecta
RA
6
Q
Major secondary causes of osteoporosis - endocrine diseases
A
Hyperthyroidism Hyperparathyroidism Cushing’s syndrome Growth Hormone Deficiency Hyperprolactinaemia Hypogonadism
7
Q
Treatment of osteoporosis - Antiresorptive therapy
A
- Calcium (1200-1500mg in >65)
- Vit D supplementation
- Smoking cessation; Decrease ETOH; Fall prevention; regular weight bearing exercise; hip protector
- Bisphosphonates (risendronate and alendronate)
- Denosumab (RANKL)
- Strontium ranelate - Oestrogen
- Selective oestrogen receptor modulators (Raloxifene)
- Calcitonin (inconsistent results)
8
Q
Treatment of osteoporosis - bone formation therapy
A
- PTH peptide
- Men with OP & androgen deficiency should be given androgen replacement unless there is a hx of prostate cancer
- Steroid induced OP: Calcium & Vit D in combination
- Surgical treatment of fractures
9
Q
Investigations in Osteoporosis
A
- DEXA
- Bloods: calcium; ALP; Vit D; PTH
- Serum electrophoresis, FBE & ESR to look for evidence of myeloproliferative disease
- Renal & LFTs to exclude hepatic & renal disease
- TSH to exclude thyrotoxicosis
- Serum testosterone in men
- Skeletal x-rays
- Iliac crest bone biopsy with double tetracycline labelling
- Tests for secondary causes of OP
