Primary Care

Question 1

Risk Factors for Osteoporosis

Answer 1

• Gender (female)
• Alcohol (drinking >3 drinks/day)
• Smoking
• Age
• Ethnicity
• Low weight
• RA
• previous hx of fractures
• family hx

Question 2

What is a t-score and z-score?

Answer 2

T-scores compare bone density with that of a healthy 30 year old man,, whereas Z-scores use the average bone density of people of the same age, sex, and size as a comparator.
Although both scores can be useful, most experts prefer using Z-scores for children, teenagers, premenopausal females, and younger males.

Question 3

How to interpret bone mineral scan results (DEXA) scan?

Answer 3

t score <-1 = osteopenia
t score <-2.5 = osteoporosis

When using age to score:
low risk = <10%
mod risk = 10-20%
high risk = >20%

Question 4

What are 4 things you want to do when screening for osteoporosis?

Answer 4

• Measure weight & height
• Measure rib to pelvis distance
• Measure occiput to wall distance
• Timed get up and go test

Question 5

Who should have a bone mineral density test (DEXA) scan?

Answer 5

• 65+ everyine
• 50-64 years (moderate risk, “skinny women who smokes”)
• <50 years (high risk, multiple lifestyle factors present)

Question 6

If low risk when would you repeat the BMD test?

Answer 6

in the next 5-10 years