Screening

Question 1

AAA screening

Answer 1

Men 65- 80 years old once

Question 2

HPV screening

Answer 2

25-69 yo, q2-3y
If ASCUS/LSIL
–> repeat in 12 months
Normal –> repeat 12 m
>=ASCUS –> refer
Normal –> back to reg screening
>= ASCUS –> refer

Question 3

Osteoporosis RFs screening

Answer 3

Risk Factors:
>50 yo
- fragility fracture >40 yo
- vertebral compression fracture or osteopenia
- parental hip fracture
- prolonged use of glucocorticoids
- > 2 falls in last year
- current smoker
- high alcohol intake
- BMI <20
-

Question 4

When to screen for Osteoporosis

Answer 4

Age 50-64 yo with previous fracture or > 2 RFs

Age 65-69 yo with 1 RF
Age >= 70 yo with no risk factors

Question 5

Osteoporosis: BMD & fracture risk with therapy recommendations

Answer 5

10 yr fracture risk < 15%
OR
T-score > -2.5
—> no TX
<10% repeat 5-10 yrs
10-15% repeat 5 yrs
> 15 repeat in 3 yrs

10 yr fracture risk 15%-19.9% OR T score <-2.5 and age <70 yr
–> suggest pharmacotherapy
repeat in 3 yrs

10 yr fracture risk >=20%
OR
T-Score <= -2.5 & age >= 70 yr
–> RECOMMEND pharmacotherapy
repeat in 3 yrs

Question 6

Tx for osteoporosis

Answer 6

1st line :Bisphosphonates

2nd line: Denosumab

treat for 3-6 years
(6 years for higher risk, hip f# or verterbral f#)

Reassess 3 yrs after stopping therapy