Osteoporosis Flashcards
What’s the scoring system?
FRAX
What does DXA show?
T score- 10 year risk of osteoporotic fracture
More than -2.5 SDs from normal
Accounts for sex and ethnicity
What lifestyle factos need addressing in osteoporosis?
Smoking
exercise
calcium in diet
What are treatment options for osteoporosis?
Oestrogens and SERMS- Raloxifene
Bisphosphonates
Calcitonin
RANKL targetted therapy- DENOSUMAB
What are risk factors for osteoporosis?
Steroids menopause CKD smoking Alcohol Female Early menopause Ethinicity Immobilisation Low diet Ca and vit D Hypogonadism
What investigations need in osteoporosis?
Calcium homeostasis-
PTH, bone profile, 24hr urine Ca, Cr, CGT, Mg
Metabolic screen- FBC, antiendomysial AB, haematiinics
Myeloma screen- ESR, protein electrophoresis
Endocrine screen- TSH, FSH, LH, prolactin, testosterone
What do you need to to taking bisphosphonates?
Stand up 1/2 hr after
No food or water before
PPI too
Weekly
What are causes of hyperCa?
Primary hyperparathyroidism
Cancer
What bloods are defs hyperparathyroid?
High Ca
High PTH
What are complications of primary hyperparathyroidism?
Hypercalcaemia
Renal stones
CV disease
Osteoporosis
How is hyper PTH managed?
80% caused by adenoma to surgery
20% caused by hyperplasia of all 4 glands
What bloods indicate secondary hyper PTH?
low vit D or low Ca (vegans)
-low phos, high alk phos, high PTH
What is the difference between osteoporosis and osteomalacia?
Malacia- normal quantity of bone but unmineralised matrix
Porosis- loss of bone density
How is secondary hyperPTH treated?
Cholecalciferol or IV ergocalciferol if malabsorption) and treat cause (malabsorption or diet etc)
Repeat DEXA
