Osteoporosis Flashcards
What is osteoporosisʔ
ɪt is a disease characterised by low bone mass and deterioration of bone tissue leading to increased bone fragility and increased risk of fracture/
What is osteopeniaʔ
Osteopenia is having low bone density. (but it is not low enough to be osteoporosis). ɪt is the precursor for osteoporosis.
What should the bone density value be for young healthy adults according to WʜOʔ
Bone density should be greater than 2.5 SD for healthy, young adults.
What bone density values classify as osteopeniaʔ
1 to 2.5 SD bone density is osteopenia
Who does osteoporosis affectʔ
50% of women and 20% of men aged 50 will have an osteoporotic fracture in their remaining lifetime.
*ʀisk of fracture increases with age
What are the typical complications of osteoporosisʔ
1) proximal femur fracture
ʜow does a vertebral crush fracture usually presentʔ
Vertebral crush fractureː
- sudden onset of severe pain in spine radiating round to the front.
- Weakness , Numbness, Tingling
- increasing kyphosis
- height loss
- Xray shows WEDɢE SʜAPED VEʀTEBʀAE*
What is fracture is likely to occure in osteoporosis after a fall on an outstretched handʔ
Colle’s fracture
What is the pathogenesis of osteoporosisʔ
- increased bone breakdown by osteoclasts.
- decreased formation of bone by osteoblasts
- leads to decreased bone mass.
***amount of bone loss depends on peak bone mass, genetics, nuitrion.
What are the risk factors for osteoporosisʔ
- Oestrogen deficiency
- Vit D deficiency
- hyperparathyroidism —> bone reabsorption
- ɢlucocorticoids (increased fracture risk within 3months of starting therapy)
What investigations are done to diagnose Osteoporosisʔ
1) X-ray (fracturesʔ)
2) DEXA scan (bone density scan) **ɢold standard **
3) CT scanning (but more expensive than DEXA, and more radiation)
What is the management of osteoporosisʔ
1) Calcium + Vit D suppliments
2) exercise (weight bearing exercise 3* week to increase bone mineral density.
3) stop smoking (smoking lowers BMD —> increased fracture risk)
4) reduce falls - home railings, physio ect.
What treatments are given for osteoporosisʔ
1) Alendronate (inhibit osteoclasts so stop bone destruction, increase BMD)
2) Strontium ranelate (alternative to alendronae)
3) ʀaloxifene (activates oestrogen receptors)
4) ʜʀT (2nd line option, but not in those with breast ca risk)
ʜow does Aldendronic acid (a bisphosponate) work to reduce risk of fracture from osteoporosisʔ
Alendronate inhibits osteoclasts to stop bone destruction and increases Bone mineral density.
ʜowever oesophagitis is a common side effect.
