osteoporosis

Question 1

presumptive diagnosis of osteoporosis

Answer 1

all individuals over the age of 50 who sustain a fracture from minimal truam a

Question 2

diagnositc investigations

Answer 2

bone mineral density scan using at least two skeletal sites

Question 3

lifestyle modifications

Answer 3

adequate calcium and protein intake
adequate but safe exposure to sunlight as a source of vitamine D
healthy BMI
cessation of smoking
avoidance of excessive alcohol consumption

Question 4

exercise

Answer 4

individuals over 50 should participate regularly in progressive resistance training and balance training exercises

Question 5

treatment

Answer 5

bisphosphonates
denosumab
hormone therapy - oestrogen replacement therapy or SERM

Question 6

SERMs may be useful for

Answer 6

women with a prior history of breast cancer

Question 7

indications to medicate for osteoporosis

Answer 7

T score < -2.5 in patients over 70
or minimal trauma fracture in patients > 50
or in corticosteroid induced osteoporosis: T score < -1.5

Question 8

denosumab

Answer 8

monoclonal antibody
reversibly inhibits bone resorption by reducing osteoclast formation and increasing osteoclast apoptosis
can be used in chronic kidney disease (unlike bisphosphonates)
6 monthly subcut injection