Osteoporosis Flashcards
What can cause osteoporosis?
Endocrine
Rheumatic
GI
Medication
What are the endocrine causes of osteoporosis?
Thyrotoxicosis Hyper and hypo parathyroidism Cushings Hyperprolactinaemia Hypopituitarism Low sex hormones
What are the rheumatic causes of osteoporosis?
Rheumatoid arthritis
Ankylosing spondylitis
Polymyalgia rheumatica
What are the GI causes of osteoporosis?
UC and Crohn’s
Liver diseases
Malabsorption
What liver diseases cause osteoporosis?
Alcoholic cirrhosis
Viral cirrhosis
Primary biliary cholangitis
Chronic active hepatitis
What are the malabsorption causes of osteoporosis?
Coeliac CF Chronic pancreatisis Whipples disease Short gut syndrome Ischaemic bowel
What medications can cause osteoporosis?
Steroids PPIEnzyme inducing anti epileptic medications Aromatase inhibitors GnRH inhibitors Warfarin
What are the risk factors for osteoporosis?
Female Women >50, men >65 Low BMI White Post menopausal Smoking Excessive alcohol use FH of maternal hip fracture
What is the most common presentation of osteoporosis?
Asymptomatic until fracture
What is the possible presentation of osteoporosis?
Asymptomatic Fracture Back pain Kyphosis Impaired gait or balance
What are the principles of osteoporosis treatment?
Minimise risk factors
Ensure good calcium and vit D status
Medication
What medications can be used to treat osteoporosis?
Bisphosphonates HRT Selective oestrogen receptor modulator Denosumab Teriparatide
What is the first line pharm treatment of osteoporosis?
Oral bisphosphonates if renal function, calcium and vit D adequate
What are the side effects of bisphosphonates?
Oesophagitis
Iritis/uveitis
Osteonecrosis of jaw
Atypical femoral shaft fractures
What are the side effects of HRT?
Increased risk of blood clot and breast cancer
Increase risk of heart disease and stroke if started once menopause has started