Osteoporosis Revision Flashcards
What are the 2 most common causes of primary osteoporosis?
1) Postmenopausal (type I)
2) Age related (type II)
What are 4 causes of 2ary osteoporosis?
1) Hyperthyroidism
2) Hyperparathyroidism
3) Alcohol abuse
4) Immobilisation
What are some major risk factors associated with osteoporosis?
- age
- gender
- steroids
- RA
- smoking
- previous fracture
- parent fractured him
- alcohol
What steroid dose is high risk of osteoporosis?
> 3 months at a dose of prednisolone 5mg daily)
Pathophysiologi of osteoporosis?
Increased bone breakdown by osteoclasts BUT decreased bone formation by osteoblasts –> decreased bone density.
What are the most common pathological fractures seen in osteoporosis?
1) Vertebral compression fractures
2) Appendicular fractures (fracture of the proximal femur or distal radius following a fall):
- NOF
- Colles fracture
Who should be assessed for osteoporosis?
1) all women aged >= 65 years and all men aged >= 75 years
2) younger patients should be assessed in the presence of risk factors e.g. previous fragility fracture, current use or frequent recent use of steroids
When should a DEXA scan be offered without calculating the fragility risk score?
1) > 50 years of age with a history of fragility fracture
2) < 40 years of age who have a major risk factor for fragility fracture
What QFracture score indicates need for DEXA?
≥10%
What does the FRAX or QFracture score assess?
10 yr risk of developing fracture
Give 3 scenarios where you would start bisphosphonate therapy right away (and note wait for DEXA)?
1) Postmenopausal women, and men age ≥50, who are treated with oral glucocorticoids
2) A postmenopausal woman, or a man age ≥50 has a symptomatic osteoporotic vertebral fracture
3) Following a fragility fracture in women ≥ 75 years
How long should oral bisphosphonates be prescribed for in osteoporosis?
At least 5 years
<75 y/o + fragility fracture?
DEXA scan
What medicat
