Osteoporosis Flashcards
What % of elderly who have a hip fracture die within one year?
20%
What is the gold standard for diagnosing osteoporosis?
DEXA scan
What is a T-score?
comparison of bone density compared to young adults
what is a Z-score?
comparison of bone density to age-matched adults
Which score is used to diagnose osteoporosis?
T-score <= -2.5
what is normal T-score?
-1 to +1
what T-score range is considered osteopenia?
-1 to -2.5
What population should you not use T-scores for?
never use in children
doesn’t apply to pre-menopausal women, or men <50y/o
When should you use a Z-score?
- pre-menopausal women
- men <50y/o
- when evaluating for secondary causes of osteoporosis
How much Calcium and Vitamin D should you get per day?
Ca2+ = 1200mg
Vit D= 1000 IU
What are the screening guidelines for osteoporosis?
- women > 65y/o and men >70 y/o
- for postmenopausal women & men btwn 50-70y/o, testing is recommended based on risk factor profile
- those who have suffered a fracture
what is the FRAX model?
risk-assessment model for osteoporosis developed by WHO that calculates the 10 yr probability of a hip fracture and any other major osteoporotic fx
the FRAX model uses Bone marrow densit from which part of the body to assess risk for osteoporosis?
-femoral neck BMD
what risk factors are included in the FRAX model?
current age gender personal hx of fracture femoral neck BMD low BMI use of glucocorticoid tehrapy secondary osteoporosis/ RA parental history of hip fx current smoking alcohol intake of 3+ drinks/day
what are the treatment guidelines for treating osteoporosis?
postmenopausal women & men >50y/o with a T-score of -1 to -2.5 AND 10yr hip fx prob >3% or 10yr major osteoporosis related fx prob >20% based on FRAX model
how often is BMD testing recommended?
every 2 years for patients on pharmacotherapy
what is the MOA of bisphosphonates?
inhibit resorption (but does not stimulate higher level of synthesis)
what is the MOA for teriparatide-forteo?
is an anabolic drug that stimulates both building and resorption (but more so in favor of building) so net effect is that bone mass and strength increase
which drug is a fully human monoclonal ab that inhibits bone resorption by neutralizing RANKL?
Denosumab
What is the function of RANKL?
key mediator of osteoclast differentiation, activation, and survival
what is the effect of PTH on bone?
continuous (high dose) PTH –> catabolic effect
daily (low dose) PTH –> anabolic effect
what is osteonecrosis of the jaw?
presence of exposed bone in the maxillofacial region that does not heal within 8 weeks after identification
osteonecrosis of the jaw is an AE of which therapeutic drug?
bisphosphonates
