Osteoporosis Flashcards

1
Q

What can cause osteoporosis?

A

Endocrine
Rheumatic
GI
Medication

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2
Q

What are the endocrine causes of osteoporosis?

A
Thyrotoxicosis
Hyper and hypo parathyroidism
Cushings
Hyperprolactinaemia
Hypopituitarism
Low sex hormones
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3
Q

What are the rheumatic causes of osteoporosis?

A

Rheumatoid arthritis
Ankylosing spondylitis
Polymyalgia rheumatica

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4
Q

What are the GI causes of osteoporosis?

A

UC and Crohn’s
Liver diseases
Malabsorption

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5
Q

What liver diseases cause osteoporosis?

A

Alcoholic cirrhosis
Viral cirrhosis
Primary biliary cholangitis
Chronic active hepatitis

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6
Q

What are the malabsorption causes of osteoporosis?

A
Coeliac
CF
Chronic pancreatisis
Whipples disease
Short gut syndrome
Ischaemic bowel
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7
Q

What medications can cause osteoporosis?

A
Steroids
PPIEnzyme inducing anti epileptic medications
Aromatase inhibitors
GnRH inhibitors
Warfarin
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8
Q

What are the risk factors for osteoporosis?

A
Female 
Women >50, men >65
Low BMI
White
Post menopausal
Smoking
Excessive alcohol use
FH of maternal hip fracture
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9
Q

What is the most common presentation of osteoporosis?

A

Asymptomatic until fracture

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10
Q

What is the possible presentation of osteoporosis?

A
Asymptomatic
Fracture
Back pain
Kyphosis
Impaired gait or balance
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11
Q

What are the principles of osteoporosis treatment?

A

Minimise risk factors
Ensure good calcium and vit D status
Medication

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12
Q

What medications can be used to treat osteoporosis?

A
Bisphosphonates
HRT
Selective oestrogen receptor modulator
Denosumab
Teriparatide
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13
Q

What is the first line pharm treatment of osteoporosis?

A

Oral bisphosphonates if renal function, calcium and vit D adequate

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14
Q

What are the side effects of bisphosphonates?

A

Oesophagitis
Iritis/uveitis
Osteonecrosis of jaw
Atypical femoral shaft fractures

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15
Q

What are the side effects of HRT?

A

Increased risk of blood clot and breast cancer

Increase risk of heart disease and stroke if started once menopause has started

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16
Q

What are the side effects of selective oestrogen receptor modulator?

A

Hot flushes
Increased clotting risk
Lack of protection at hip

17
Q

How does denosumab work?

A

Monoclonal antibody that reduces osteoclastic bone resorption

18
Q

When is denosumab used?

A

In significant renal failure

19
Q

What are the side effects of denosumab?

A

Allergy/rash
Symptomatic hypocalcaemia
Osteonecrosis of jaw
Atypical femoral shaft fractures

20
Q

What are the side effects of teriparatide?

A

Injection site rash
Rarely hypercalcaemia
Allergy