Osteoporosis Flashcards
Describe the types of osteoporosis
Primary–> Age related and post-menopausal
Secondary–> Drug related, secondary to other conditions
What are the risk factors for osteoporosis?
Mneumonic ‘Shattered’:
(Cortico)Steroid use Hyperparathyroidism, hyperthyroidism Alcohol, tobacco use Thin (low BMI) Testosterone decreased Early menopause Renal, liver failure Erosive bone disease e.g. myeloma, rheumatoid arthritis Dietary calcium decreased Also parental hip fracture
What investigations are used to diagnose osteoporosis? What does it measure, explain results.
DEXA bone densitometry
Measures bone mineral density
T score<2.5= Osteoporosis
between -1 and -2.5= Osteopenia
What do you use to decide whether to treat?
FRAX tool
What are the common complications of osteoporosis?
Vertebral compression fracture
Decreased vertebral height
Thoracic hyperkyphosis (stooped with a dowagers hump)
Femoral neck fractures
What are the two mainstays of management of osteoporosis?
Lifestyle
Pharmacological
What lifestyle interventions can be used in osteoporosis?
Quit smoking
Reduce alcohol
Encourage physical activity
Fall prevention
What is the first line pharmacological treatment for osteoporosis?
Bisphosphonates
Give examples of bisphosphonates, describe mechanism of action.
Alendronate, Risedronate
Inhibits osteoclastic bone reabsorption
What are the S/Es and contraindications of bisphosphonates?
Hypocalcaemia, hypophosphataemia Atypical fractures Aseptic osteonecrosis of the jaw Oesophageal irritation Contraindicated for oesophageal abnormalities and hypocalcaemia
Name three other osteoporosis medications, their mechanisms and why they are used.
Teriparatide
Parathyroid hormone analogue
Useful for those who still have fractures despite treatment
Raloxifene
Selective oestrogen receptor modulator (SERM)
Similar to HRT, helping to prevent osteoporosis in post-menopausal women
Denosumab
Monoclonal antibody against RANK ligand
Given subcutaneously twice a year
