Osteoporosis

Question 1

What is osteoporosis?

Answer 1

presence of bone mineral density (BMD) of less than 2.5 standard deviations (SD) below the young adult mean density.

Question 2

What are risk factors for osteoporosis?

Answer 2

Age
Female
corticosteroid use
smoking
alcohol
low body mass index
family history

Question 3

What are screening tools?

Answer 3

FRAX - 10 year risk of fracture

QFracture

Question 4

What are the most common sites for fractures?

Answer 4

thoracic and lumbar vertebrae
proximal femur
distal radius (Colles)§

Question 5

What risk factors are assessed in the FRAX tool?

Answer 5

history of glucocorticoid use
rheumatoid arthritis
alcohol excess
history of parental hip fracture
low body mass index
current smoking
previous fracture

Question 6

What is a DEXA score between -1 and -2.5

Answer 6

osteopenia

Question 7

What is a normal DEXA scan

Answer 7

> -1

Question 8

What is z score adjusted for?

Answer 8

age
gender
ethnic factors

Question 9

What is the treatment of osteoporosis?

Answer 9

alendronate
(then zoledronic acid, strontium ran elate, raloxifine)
+ vit D and calcium supplementation

Question 10

What blood tests should you do?

Answer 10

full blood count
urea and electrolytes
liver function tests
bone profile
CRP
thyroid function tests

Question 11

What is denosumab, how does it work?

Answer 11

human monoclonal antibody that inhibits RANK ligand, which in turn inhibits the maturation of osteoclasts