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Hcoll > Osteoporosis > Flashcards

Osteoporosis Flashcards

1
Q

Definition of Osteoporisis

A

Decreased bone mass + Architectural deterioration causing increased risk of pathological fractures

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2
Q

What gender is more at risk for osteoporosis

A

Female

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3
Q

What is the usual first presentation for osteoporosis

A

a fracture, as it is asymptomatic

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4
Q

What type of fractures occur most commonly in osteoporosis

A

Wrist
Hand
Vertebrae

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5
Q

What is a Colles Fracture

A

A fracture that occurs when you fall on an outstretched hand

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6
Q

What is the best investigation for bone density and how do you interpret it

A

DEXA Scan

Gives a T score, >2.5 SD of regular adult = osteoporosis

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7
Q

What is a T score

A

Comparison of measured bone mass to a 30-year-old adult of the same sex

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8
Q

What is a Z score

A

Comparison of bone mass to the average bone mass of a healthy person of the same age and gender

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9
Q

When would you use a Z score over a T score

A

When the patient is below 50 §

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10
Q

Is osteoporosis is suspected, what investigations should be done

A 
U+E (Renal function) 
Bone Profile 
Vit D levels
TFT
Bone turnover
Multiple Myeloma screeen (ESR, Serum Immunoglobins, protein electrophoresis, Urinary bence jones protein) 
DEXA Scan
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11
Q

Why is renal function important in measuring bone density

A

Kidneys are responsible for Vit D metabolism

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12
Q

What are some drugs that may cause osteoporosis

A 
Steroids
Anti-sex hormones (finasteride, Gosrelin) 
Lithium
Anti-convulsants
Heparin
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13
Q

What endocrine disorders lead to osteoporosis

A

Cushings
Acromegaly
Hypopituitarism
Prolactinoma

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14
Q

What inflammatory conditions lead to osteoporosis

A

Rheumatoid Arthiritis
Ankylosing Spondylitis
IBD

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15
Q

Deficiency in what nutrients cause an increased risk of osteoporosis

A

Vit D

Ca2+

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16
Q

What conditions cause a nutritional deficiency

A

Malabsorption Syndrome
Diarrhoea
Coeliacs
IBD

17
Q

What genetic conditions may cause osteoporosis

A

Marfans
Osteogenesis Imperfectica
Turners syndrome

18
Q

Osteoporosis risk factors

A
  1. FHx
  2. Smoking
  3. Excess Alcohol
  4. Steroids + osteoporitic drugs
  5. Low Oestrogen, seen in amenorrhoea (no periods 6+ months), Late Menarche, Early Menopause
  6. Immobility
  7. Inflammatory conditions like RA, ankylosing spond etc
  8. Gastrectomy
19
Q

What lifestyle modifications can be made to treat osteoporosis

A

Increase Calcium intake
Weight-bearing Exercise
Smoking Cessation
Decrease Alcohol consumption if excessive

20
Q

What equipment is available for people with

osteoporosis

A

Hip protectors

21
Q

What medications are available for treating osteoporosis

A 
Vit D
Calcium ion supplementation
Bisphosphonates (e.g. alendronic acid 70mg ow)
Selective oestrogen receptor modulators (Raloxefine)
Strontium
HRT
Testosterone
PTH
22
Q

What’s required for bisphosphonate therapy to start

A

Normal Vitamin D levels

23
Q

Side effects of Bisphosphonates

A

GORD
Jaw Necrosis
Renal Toxicity

24
Q

What is the treatment pathway for osteoporosis

A
  1. Lifestyle advice + Bisphosphonates + Ca + Vit D supplementation
  2. Hormone replacement (if deficient), Oestrogen receptor modulation + Supplementation OR Denosumab (mAB) + Supplementation
25
Q

What is the maximum treatment length for bisphosphonates

A

3 years

26
Q

Side effect of strontium

A 
Diarrhoea
Nausea
IHD
VTE
Allergy
27
Q

Side Effect of selective oestrogen receptor modulators

Raloxefine

A

VTE
Hot flushes
Leg Cramps

28
Q

Osteoporosis prognosis

A

20% excess mortality due to hip fracture

50% don’t get full function following pathological fracture

29
Q

How would you advise a bisphosphonate like alindronic acid

A

Must be taken on an empty stomach with a full glass of water + no food for 30 mins

Hcoll (15 decks)

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