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DM 2 - Gynecology > Osteoporosis > Flashcards

Osteoporosis Flashcards

1
Q

What percentage of women suffer an osteoporotic fracture during their lifetime

A

40%

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2
Q

What are the common sites of fracture (3)

A
  • wrist
  • hip
  • vertebrae
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3
Q

Definition of osteoporosis

A

Bone mineral density -2.5 SD or less using the T score

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4
Q

What is the T score

A

The number of standard deviations by which the individuals BMD differs from that of an average 25 year old woman.

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5
Q

What is a normal T score

A

Not less than -1 SD

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6
Q

What is the T score in keeping with osteopenia

A

Between -1 SD and - 2.5 SD

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7
Q

What are the general risk factors for osteoporosis (6)

A
  • increasing age
  • female sex
  • low BMI (<19)
  • previous fragility fracture
  • parental history of hip fracture
  • current glucocorticoid therapy >3months
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8
Q

What are lifestyle factors associated with osteoporosis (3)

A
  • current smoking
  • alcohol intake 3units or more
  • sedentary lifestyle
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9
Q

What are secondary medical causes of osteoporosis ? (7)

A
  • rheumatoid arthritis
  • type 1 DM
  • hyperthyroidism
  • malabsorption syndrome
  • chronic liver disease
  • COPD
  • organ transplantation
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10
Q

How can the sensitivity of the BMD be improved

A

By using the (fracture risk assessment ) FRAX tool.

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11
Q

What are the indications for BMD screening (4)

A
  • estrogen deficiency
  • fragility fracture
  • high risk of osteoporosis
  • intermediate risk FRAX tool
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12
Q

What is thr management of low risk (frax)

A

Reassure and reassess in 5 years

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13
Q

What is the management of intermediate risk (frax)

A

Measure BMD and recalculate the fracture risk

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14
Q

What is the management of high risk (frax)

A

Can be considered for treatment without the need for BMD

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15
Q

What are lifestyle modifications to decrease the risk of osteoporosis (5)

A
  • calcium 1000mg
  • vitamin D 400 IU
  • exercise: weight bearing, low impact
  • smoking cessation
  • avoiding excessive alcohol
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16
Q

What is the first line drug for osteoporosis

A

Alendronate 70 mg once a week

17
Q

What are other agents for osteoporosis (4)

A
  • etidronate (bisphosphonate)
  • risedronate (bisphosphonate)
  • denosumab ( human monoclonal antibody)
  • raloxifene (SERM)
18
Q

Duration of medical therapy for osteoporosis

A

Indefinite

19
Q

What is the monitoring protocol for osteoporosis

A
  • insufficient evidence to determine value of routine BMD
  • If indicated, should be after 2 years of therapy
20
Q

How are bisphosphonates taken

A

Once a week, in the morning on an empty stomach

DM 2 - Gynecology (22 decks)

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