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Flashcards in 2.4 osteoporosis Deck (18)
1

What is the WHO criteria for osteoporosis?

BMD T score >-2.5

2

what is the difference between osteoporosis and osteomalacia?

Osteoporosis occurs when the bone matrix is normally mineralised but there is less bone
Osteomalacia is when there is insufficient calcium and phosphate to mineralise newly formed osteoid leading to bone being softer and more liable to bend and deform

3

How is osteoporosis diagnosed?

In relation to the degree to which bone mineral density is reduced
T score: SD away from young normal mean
Z score: SD away from aged matched mean
T

4

where do they measure BMD from?

Spine (L1-4 or 2-4) - trabecular bone and useful for monitoring

Hip - cortical bone

5

What are the advantages and limitations of BMD?

Ad: quick and easy, minimal radiation exposure, widely used in clinical trials

Dis: mineral content across a specific area not taking depth into consideration, does not provide full assessment of bone strength, variation between instruments

6

What is the FRAX tool?

tool that takes into account clinical risk factors as well as BMD at femoral neck giving a 10 year probability of a fracture occuring

7

What occurs with the cells in osteoporosis?

There is an increase in osteoclast activity and the osteoblasts do not have enough time to lay down new bone

8

What are the preventative strategies for osteoporosis?

Calcium intake
Exercise
Avoid smoking and excessive alcohol
Weight bearing exercise
Vitamin D

9

What do effective treatments for osteoporosis need to do?

Increase bone density and reduce fracture rates

10

How do bisphosphonates work?

They go into the bone and stay there and when the osteoclasts are trying to dig the herniation pit they will take up the bisphosphonates and undergo apoptosis

11

What are the SE of bisphosphonates

Osteonecrosis of the jaw

12

What is the RANKL inhibitor and how does it work?

Denosumab
Inhibits osteoclast formation, function and survival

13

What is SERM and give an example

Selective oestrogen recptor modulator. Acts on estrogen receptors in the bone and not breast tissue
Raloxifene

14

How does parathyroid hormone work in osteoporosis and what is the drug called?

Teriparatide
Works by increasing serum calcium by increasing bone resorption. With intermittent exposure it activated osteoblasts more than osteoclasts

15

What drugs are used in post menopausal osteoporosis?

Bisphosphonates
Denosumab
SERM
2nd line: strontium and parathyroid hormone

16

What drugs are used for men with osteoporosis?

Bisphosphonates and strontium ralenate

17

What drugs are used for corticosteroid induced osteoporosis?

Pednisolone
Bisphosphonates

18

What drugs are used for primary prevention of osteoporosis?

Bisphosphonates and denosumab