Osteoporosis Flashcards
What are risk factors
low BMI Smoking Alcohol CS use FHx RA Sedentary lifestyle Early menopause
What is FRAX
Screening tool to assess risk of fracture in next 10yrs
Who is assessed for osteoporosis?
All women 65 and over and men 75 and over
Younger ppl in the presence of RFs
What does FRAX include
age sex BMI Prev. fracture Parental fracture Smoking Glucocorticoids RA Secondary osteoporosis Alcohol intake BMD
What does a DEXA scan measure?
Bone mineral density
when should DEXA scan be used
if starting Rx that may have rapid adverse effects on density e.g. hormone Rx for breast/prostate Ca
<40yrs w major RF
Explain DEXA scoring and what would indicate a diagnosis of osteoporosis
Uses T score - compares BMD to healthy bone of 30yo
T score less than -2.5 = osteoporosis
T score -1 to -2.5 = osteopenia
What is Z score? When is its use preferred?
Compares BMD to someone ur age and body size
Preferred in children, teens, women w periods and younger men
What is the lifestyle management of osteoporosis
- increase physical activity
- stop smoking
- reduce alcohol (<2units a day)
- Reduce risk of falls
- Adequate Ca intake and vit D status
What is pharmacological management of osteoporosis?
- Alendronate (10mg OD or 70mg weekly) or risedronate for postmenopausal women and men >50yrs (only these 2 bisphosphonates ok for men)
- Raloxifine - selective oestrogen receptor modulator - increased risk of VTE/PE
- HRT if premature menopause (must have vasomotor sx)
- Vit D supplementation
- Calcium supplementation if inadequate intake
What are the SE of alendronate
Upper GI sx
Atypical femoral fractures
What levels are known to cause glucocorticoid induced osteoporosis
Prednisolone 7.5mg OD for ≥3 months
What is the Rx of glucocorticoid induced osteoporosis
alendronate, calcium and vit D replete
How does oesteoporosis tend to present?
Fracture
What are the types of fractures that can occur due to osteoporosis?
- Vertebral crush fracture
- Colles’ fracture (distal radius) - FOOSH
- Proximal femur - older individuals falling on their side or back
