Osteoporosis Flashcards
What is osteoporosis?
Osteoporosis is a progressive bone disease characterized by low bone mass and microarchitectural deterioration of bone tissue, leading to an increased risk of fragility fractures.
What is a fragility fracture?
A fragility fracture is defined as a fracture following a fall from standing height or less. Common fractures occur in the wrist, spine, and hip.
What is bone mineral density (BMD)?
BMD refers to the measurement of calcium and other minerals in your bone, indicating the amount of mineral content within a specific volume of bone.
How is BMD measured?
BMD is measured using a DEXA scan (Dual-Energy X-ray Absorptiometry), which uses low-dose X-rays to assess bone density and strength.
What is the T-score in BMD measurement?
The T-score is the number of standard deviations below the mean BMD of young adults at their peak bone mass, used to assess the degree of osteoporosis.
When should a 10-year fragility fracture risk score be calculated?
It should be calculated before arranging a DXA scan or starting bisphosphonate treatment -
except in people over 50 years with a history of fragility fractures or under 40 years with a major risk factor for fragility fracture.
What is the preferred tool for calculating fragility fracture risk?
The preferred tools for calculating fragility fracture risk are the QFracture® and FRAX® online assessment calculators.
What risk score indicates high fragility fracture risk?
A high-risk score is 10% or greater on the QFracture® calculator or a “red zone” result on the FRAX® risk chart.
What are some common risk factors for osteoporosis?
Common risk factors include increasing age, vitamin D deficiency, low calcium intake, lack of physical activity, low BMI, smoking, excess alcohol intake, parental history of hip fractures, early menopause, and certain diseases like rheumatoid arthritis and diabetes.
What drug treatment should be given if calcium intake is inadequate?
If calcium intake is inadequate, prescribe 10 micrograms (400 international units) of vitamin D with at least 1000 mg of calcium daily.
What are the first-line bisphosphonate options for postmenopausal osteoporosis?
The first-line bisphosphonates for postmenopausal osteoporosis are alendronic acid and risedronate sodium.
What treatment is recommended for glucocorticoid-induced osteoporosis?
The first-line treatment is oral bisphosphonates like alendronic acid or risedronate sodium. Alternatives include zoledronic acid, denosumab, or teriparatide.
How long should bisphosphonate treatment be reviewed for?
Bisphosphonate treatment should be reviewed after 5 years for alendronic acid, risedronate sodium, or ibandronic acid, and after 3 years for zoledronic acid.
