Osteoporosis Flashcards
What is osetoporosis?
Low bone mineral density
What is primary osteoporosis?
Age-related
What is secondary osteoporosis?
Secondary to another condition/drugs
What does SHATTERED stand for?
Steroid use Hyperthyroidism/parathyroidism/calciuria Alcohol and tobacco Thin Testosterone low Early menopause Renal or liver failure Erosive/inflammatory bone disease Dietary low calcium/malabsorption or Diabetes type 1
What bone densitometry method is used?
DEXA
Where is best to scan during DEXA?
Hip
What is bone mineral density compared to in DEXA?
To the BMD of a young healthy adult
What is the T-score?
Number of standard deviations the BMD is from the youthful average
What does a T-score from 0 to negative 1 mean?
Normal
What does a T-score from negative 1 to negative 2.5 mean?
Osteopenia
What does a T-score of negative 2.5 or worse mean?
Osteoporosis
What is normal on a blood test?
Calcium, phosphate, ALP
What lifestyle management is there?
Exercise, maintain a healthy weight, stop smoking, reduce alcohol
What is the first line management?
Bisphosphonates and supplements
What supplements would you give?
Calcium and vitamin D
What prevention can you give to post-menopausal females?
HRT
What is denosumab?
A monoclonal antibody to RANK ligand and therefore blocks activity of osteoclasts
When is denosumab given?
As second line management
How often do you repeat DEXA?
Every 2 years
Which fractures are more common if trabecular bone is affected?
Crush fractures of vertebrae
Which fractures are more common if cortical bone is affected?
Long bone fractures
What is a FRAX score?
Fracture risk assessment tool. 10 year probability of a major osteoporotic fracture/hip fracture
Give examples of bisphosphonates
Alendronate/alendronic acid, risendronate, zolendronic acid
What is AdCal?
Vitamin D and calcium supplement
What do bisphosphonates do?
Inhibit bone resorption through the inhibition of farnesyl pyrophosphate synthase which reduces osteoclast activity
What is a side effect of bisphosphonates?
Oesophagitis
