Osteoporosis Flashcards
What is osteoporosis?
A significant reduction in bone density
What are the T and Z scores?
T score - bone density compared to that of the average healthy young adult
Z score - bone density compared to the average for their age, sex and ethnicity
What T score is diagnostic of osteoporosis?
< -2.5
What are the risk factors for osteoporosis?
Older age
Post-menopausal
Reduced mobility
Low BMI
Low calcium or vit D intake
Alcohol and smoking
Personal or family history of fractures
Long term corticosteroids
Chronic diseases
What scores can be used to calculate the risk of fracture?
QFracture
FRAX tool
What QFracture score necessitates a DEXA scan?
> 10%
When should bisphosphonates be started without a DEXA scan?
Post-menopausal or man aged > 50 with a vertebral fracture
Post-menopausal women and men age > 50 treated with oral glucocorticoids
Fragility fracture in women > 75
What is the first line treatment of osteoporosis?
Bisphosphonates
What lifestyle advice should be given to those with osteoporosis?
Increase physical activity
Maintain a healthy weight
Stop smoking
Reduce alcohol consumption
Increase intake of calcium and vitamin D
What are the side effects of bisphosphonates?
Reflux
Oesophagitis
Atypical fractures
Osteonecrosis of the jaw
How are bisphosphonates taken?
Taken on an empty stomach, with a full glass of water
Sit upright for 30 minutes after taking
What is the management of a patient who has been on bisphosphonates for more than 5 years?
Repeat DEXA scan
Stop bisphosphonates if T score > -2.5
