Osteoporosis Flashcards
What is osteoporosis?
a quantitative defect characterised by reduced mineral density and increased porosity
What does osteoporosis lead to?
fragility and risk of fracture
What number of standard deviations must be a patient be below for bone density to be diagnosed with osteoporosis?
< 2.5
Which gender is more at risk?
females after menopause
Why is being post menopause a risk?
less oestrogen circulating that is protective
At what age does osteoblast activity decrease?
30 years old
What rate does osteoblast activity decrease?
very slow
How many types of osteoporosis are there?
2
What is type I?
Post menopausal osteoporosis
Who is more at risk of type I osteoporosis?
white Caucasians
What causes type I osteoporosis?
familial and environmental factors
What common pathological features are associated with type I osteoporosis?
colles fractures and vertebral instability
What is type II?
Osteoporosis of old age
What defines type II osteoporosis?
greater deterioration than expected of the bone
what pathological features are associated with type II?
femoral neck fractures and vertebral fractures
Type II can be secondary to what other conditions?
corticosteroid use, alcohol abuse, malnutrition, chronic disease (CKD, malignancy, Rheumatoid arthritis) and endocrine disorders (Cushing’s, Hyperthyroidism, Hyperparathyroidism)
What can cause type II osteoporosis?
vitamin D deficiency
How do you diagnose osteoporosis?
Dexa scan
What is the aim of treatment?
To slow progression as you can’t regain the density
Why don’t you often prescribe intranasal calcitonin?
similar effectiveness but a high cancer risk
What are the main treatment options?
Vit D and calcium supplements, change in diet, sunlight exposure, bisphosphates, Desuromab, Strontium, Zoledronic acid
Which bisphosphates would you give and why?
alendronate, risedronate, etidronate which reduce osteoclastic resorption
What is Desuromab?
a monoclonal antibody which reduces osteoclast activity
Why would you give Strontium?
increases osteoblast replication and reduces resorption
How is Zoledronic acid given?
IV
Why is HRT not first line?
Risk of breast cancer, Endometrial cancer and DVT
Why is Raloxifene not first line?
Risk of DVT
