Osteoporosis Flashcards
what is osteoporosis
osteopenic disease characterised by low bone density, resulting in increased bone fragility and susceptible to fracture
what are the risk factors
female sex and age above 50
males above 65 are at risk
use mneumonic SHATTERED FAMILY
what causes osteoporosis in old females
main cause of osteoporosis is bone loss due to a drop in your body’s oestrogen levels
calcium deficiency too can cause osteoporosis
what is SHATTERED FAMILY
S- steroid use
H- hyperthyroid/ hyperparathyroid
A- alcohol and smoking
T- thin
T- testosterone deficiency
E- early menopause
R- renal/ liver failure
E- erosion of bone
D- diabetes
FAMILY history
presenting symptoms of osteoporosis
back pain, kyphosis, impaired vision, impaired gait and imbalance
lower extremity weakness
what investigations will be done
DEXA scan (dual energy x-ray absorptiometry)
EXA scan (Gold standard)
X-rays (wrist, heel, spine, hip) if fractures suspected
MRI spine (to look for vertebral fracture)
lifestyle advice
Reduce risk factors - eg. stop smoking, better diabetic control
Diet - adequate vitamin D, calcium, protein
Regular weight bearing exercise
Hip protectors in nursing home patients
what is the first line pharmalogical treatment for osteoporosis
Bisphosphonates: - First line - Given weekly - Incorprated into osteoclast cells and interfere with cell function causing cells to be non-functional and apoptose
what are some risks/ side effects of osteoporosis
Patients should be able to tolerate sitting up for at least 30 minutes after dose and drink with glass of water to ↓risk of developing oseophageal ulcer
Other side effects include: atrial fibrillation, osteonecrosis of the jaw, atypical stress fractures
other treatment options for osteoporosis
Denosumab
Raloxifene - used in postmenopausal women
Hormone replacement therapy (in women with premature menopause)
