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Ortho AM > Osteoporosis > Flashcards

Osteoporosis Flashcards

1
Q

What causes osteoporosis?

A

Imbalance between bone resorption and formation

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2
Q

What is the hormone physiology of osteoporosis?

A

Decrease oestrogen –> increased resorption and decreased formation in weight bearing bones
Increased PTH –> increased resorption

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3
Q

What are the types of osteoporosis?

A

Primary- type I and II

Secondary

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4
Q

What is type I osteoporosis?

A

Oestrogen deficiency after menpause

Affects mainly trabecular bone

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5
Q

What causes type II osteoporosis?

A

Age related decrease in osteoblastic activity

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6
Q

What are some secondary causes of osteoporosis?

A 
Endocrine
Malignancy
GI
Rheumatic
Drugs
Lifestyle
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7
Q

What are some endocrine causes of osteoporosis?

A 
Premtuure menopause
Anorexia nervosa
Cushings
Hyperthyroid
Hyperparathyroid
Hypogonadism
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8
Q

What malignancy is esp associated with osteoporosis?

A

Myeloma

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9
Q

What are some GI causes of osteoporosis?

A

Malabsorption
Chronic liver disease
IBD

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10
Q

What drugs can cause osteoporosis?

A

Steroids

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11
Q

What lifestyle factors can cause osteoporosis?

A

Immobilisation
Alcoho;
Smoking

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12
Q

What is the presentation of osteoporosis?

A

Usually asymptomatic until fracture
Back pain
Kyphosis

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13
Q

What are the 5 classic osteoporotic fractures?

A 
Wrist
Proximal humerus
hip
Vertebrae
Ankle
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14
Q

How is osteoporosis diagnosed?

A

Ca, phosphate and ALP normal
Hormone levels
DEXA= low bone density
FRAX and T score <2.5

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15
Q

What are the management principles of osteoporosis?

A

Treat underlying cause
Calcium and vit D
Falls prevention
Medication

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16
Q

What is the 1st line medication for osteoporosis?

A

Bisphosphonates e.g. allendronic acid

17
Q

What are the prerequisites for bisphosphonate therapy?

A

Good vit D and calcium status
Adequate renal function
“Drug holiday” for 1-2 years after 10 years use

18
Q

What are the side effects of bisphosphonates?

A

Osteonecrosis of jaw

Atypical femoral shaft fractures

19
Q

What are some 2nd line options for osteoporosis?

A

Denosumab- monoclonal antibody that reduced osteoclastic bone resorption
Teriparitide

20
Q

What is the use of denosumab?

A

Safer in significant renal failure

21
Q

What are the side effects of denosumab?

A

Symptomatic hypocalcaemia

Allergy

Ortho AM (23 decks)

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