Osteoporosis

Question 1

Osteoporosis BMD

Answer 1

<2.5 standard deviations below mean and T-score = -2.5

or

Severe osteoporosis: BMD -1 to 2.5 (osteopenia) + fragility fracture

Normal: >/= -1 SD

Question 2

MC fractures in osteoporosis

Answer 2

Vertebral fractures

Question 3

Standard for measuring bone density

Answer 3

DEXA

Question 4

Preferred sites for BMD

Answer 4

Femoral neck or total femur and/or lumbar spine

Distal third of radius if cannot evaluate spine/hips

Question 5

Used to identify and individual’s risk for osteoporosis in areas where DEXA is not available

Answer 5

Osteoporosis Screening Tool for Asians (OSTA)

Question 6

Used to assess fracture probability in all postmenopausal women with at least one WHO risk factor, prior to undergoing central DEXA

Answer 6

Fracture Risk Assessment Tool (FRAX)

Question 7

Indications for BMD

Answer 7

Women >/= 65 or Men >/= 70 regardless of risk factors

Younger postmenopausal women, women in menopausal transition, and men 50-69 years with risk factors for fracture

Adults who have fracture after 50

Adults with conditions associated with low bone mass or bone loss

Question 8

Indications to treat if with BMD measurement

Answer 8

Vertebral compression fracture evident on VFA confirmed through radiograph (clinical osteoporosis)

BMD T-score = 2.5 SD

Question 9

Indications to treat if without BMD measurement

Answer 9

Belongs to high-risk category based on OSTA tool where central BMD cannot be done or not available

10-year probability of hip fracture >/= 3% or any major osteoporosis related fracture >/= 20% based on FRAX estimates

Question 10

Recommended calcium supplementation to prevent osteoporosis

Answer 10

750-800 mg daily x 2 years to prevent bone loss

Question 11

Recommended vitamin d3 supplementation to prevent osteoporosis

Answer 11

10-20 mcg + 1000mg Ca (esp with limited sun exposure)