Osteoporosis Flashcards
What % of F over 50 will have an osteoporotic fracture in their lifetime
1/3
What % will die after a hip fracture?
33%
WHO definition of OP
Bone mineral density >2.5SD below that of a young adult male
What T value is classed as osteopaenia?
1-2.5
When does bone mass peak?
20-30
When do women have an accelerated bone loss phase?
After menopause (because O deficiency)
What are the stages of bone remodelling
Activation osteoclasts
Aggregation + adherence of osteoclasts
Osteoclastic breakdown bone matrix, releasing Ca, minerals + active GF
RF OP (9)
F Previous fragility fracture Maternal Hx hip fracture Current smoker Alcohol intake >3units/day Glucocorticoids >3m at 5mg/day Low Ca + vit D defic Genetics Low BMI <19
2’ causes of OP (9)
RA Hyperthyroidism Steroid induced Cushings Premature menopause Chronic malabsorption COPD Prolonged bed rest CLD
OP on xray
Bone appears > radiolucent than norm w/ looser zones
Sx OP (4)
Fragility fractures
Back pain
H loss
Kyphosis
How to work out the 10 year risk fractures
FRAX tools
Ix OP
Bloods
DEXA
Whole spine Xray
CTX levels
What is a T score
Av 25 y/o BMD
What is a Z score
Age matched control
Indications DEXA (6)
Low impact fracture Steroid Tx 3> months Early menopause Hip fracture either parents Conditions which affect bones BMI <18
Mx OP
Vit D + co-admin Ca
Bisphosphonates = mainstay
How do bisphosponates work
Inhibit osteoclastic bone resorption
How long do pt receive bisphosphonates for
3-5y
Most commonly prescribed bisphosphonate
Alendronate
Indications alendronate
Fragility fracture
Over 75
Post menopausal
Sites benefited - alendronate (3)
Hip
Vertebral
Non-vertebral
Cautions - alendronate (3)
UGI SE
Poor bio-availability
Cautions - bisphosphonates (4)
Renal impairment
Planned dental extraction
Osteonecrosis of the jaw
Atypical femoral fracture
