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Osteo And Rheum > Osteoporosis > Flashcards

Osteoporosis Flashcards

1
Q

What is primary OP?

A

Age related

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2
Q

What is secondary Op?

A

Caused by other conditions or drugs

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3
Q

What becomes more likely if trabecular bone is affected?

A

Crush fractures of the vertebrae (hence little old ladies)

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4
Q

What becomes more likely if cortical bone is affected? Which can be esp dangerous if it affects where?

A

Long bone fractures, especially the femoral head fracture which can be lethal

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5
Q

Which sex is more likely to be affected?

A

Women (also have increased risk of fracture as they loose more trabeculae with age whereas the number in men remains more stable)

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6
Q

What are the risk factors for developing primary OP?

A

FMH, drinking more than 4 units of alcohol a day, RA, bmi below 22 (the normal level), prolonged immobility and untreated menopause

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7
Q

What is the acronym for secondary OP?

A

SHATTERED

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8
Q

What does ‘shattered’ stand for?

A

Steroids, hyperparathyroidism/hyperthyroidism/hypercalciuria, alcohol and tobacco use, thin (BMI less than 22), testosterone levels reduced, early menopause, renal or liver failure, erosive/inflammatory bone disease (RA), dietary calcium low/malabsorption/diabetes t1

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9
Q

Investigations are?

A

XR, dexa scan, bloods UE, FBC, investigations for any secondary cause suspected eg GFR and LFTs

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10
Q

Which bone do they scan with a dexa?

A

The hip

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11
Q

What is bone mineral density measured in?

A

G/cm2

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12
Q

What is the T score?

A

The number of standard deviations from the youthful healthy average

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13
Q

Each increase in T score multiplies the risk of fracture by what amount?

A

2.6 times

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14
Q

With reference to T score what is osteopenia? What should you do?

A

-1 to -2.5 at risk of developing osteoporosis, offer lifestyle advice

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15
Q

What is osteoporosis with reference to t score? What should you do?

A

A score below -2.5 offer lifestyle advice and treatment

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16
Q

If diagnosed with OP what should you do in 2 years?

A

Repeat dexa

17
Q

When should you do a dexa scan?

A

Low trauma fracture, women older than 65 with a risk factor or younger with 2 rfs, prior to prendisalone treatment, men or women with osteopenia with low trauma vertebral fracture, bone and bone remodelling conditions

18
Q

When do you not need to do a dexa scan?

A

Pre-treatment for Women over 75 with: low trauma fracture, RA, alcoholism or positive FMH

19
Q

What is osteoporosis?

A

Skeletal disease characterised by low bone mass and micro-deterioration of bone tissue resulting in bone weakness and susceptibility to fracture

20
Q

WhT scoring system is used to estimate the risk of fracture in the next 10 years?

A

The FRAX scoring system

21
Q

What lifestyle measures can be taken?

A

Quit smoking, reduce alcohol, weight bearing exercise, balance exercises, calcium and vitamin d rich diet, home based fall prevention program

22
Q

What is the 1st line treatment for OP?

A

Alendronic acid (bisphosphosphonate) and used for prevention in long term steroid use.

23
Q

How must you take alendronic acid?

A

Sat upright, before food with lots of water, remain upright and don’t eat or take other meds for 30 mins

24
Q

What are the side effects of alendronic acid?

A

Dysphagia, strictures and rarely jaw osteonecrosis

25
Q

What might you give supplement wise?

A

Calcium, vitamin D

26
Q

If intolerant to bisphosphosphonates the. What should you give?

A

Sodium ranelate

27
Q

What preventative measure for women going into menopause can be given?

A

HRT

28
Q

What does HrT increase the risk of?

A

Breast cancer

29
Q

What treatment is given to hypo gonadal me Not?

A

Testosterone to increase trabecular interconnections

30
Q

What treatment can be used like HrT with less risk of breast cancer?

A

Raloxifene

31
Q

How does prendisalone cause osteoporosis (SIOP)?

A

Direct osteoblast inhibition, enhances bone resorption, inhibits Ca absorption, increases loss by inhibiting calciferol release by interstitial cells, inhibits sex hormones

32
Q

Is mineralization decreased in OP?

A

No there is only bone loss

Osteo And Rheum (8 decks)

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