Bone Protection Flashcards

1
Q

What questionnaires exist to assess risk of osteoporosis

A

FRAX

Q fracture

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2
Q

What demographic information is covered in osteoporosis risk questionnaires

A
Age
Sex
Height
Weight
Ethnicity
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3
Q

What social information is covered in osteoporosis risk questionnaires

A

Smoker
Alcohol >3 units per day
Live in care home

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4
Q

What PMH is covered in osteoporosis risk questionnaires

A
Diabetes
Dementia
Cancer
Asthma or COPD
MI/CVA/TIA/angina
PD
CKD
Liver failure
RA
Malabsorption
Endocrine disorder
Falls history 
Previous fracture
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5
Q

What drug history is covered in osteoporosis risk questionnaires

A
Anticonvulsants 
Antidepressants
Glucocorticoids
ERT
Aromatase inhibitors
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6
Q

What FH is covered in osteoporosis risk questionnaires

A

Parent with:
Osteoporosis
Fractured hip

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7
Q

Which questionnaire includes DEXA scan

A

FRAX (femoral neck bone mineral density)

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8
Q

What gynae history is covered in osteoporosis risk questionnaires

A

Age of menopause

ERT

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9
Q

What should prompt a bone health assessment

A

Fragility fracture needs blood test and DEXA scan

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10
Q

What is a fragility fracture

A

Fracture caused by fall or trauma from standing height or less

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11
Q

Problems with bone health in order of decreasing prevalence

A
Osteoporosis
Vitamin D deficiency (osteomalacia)
CKD (hyperparathyroidism) 
Malignancy
Paget's disease
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12
Q

Investigations for bone health

A
U&Es
Calcium
Phosphate
Vitamin D
TFTs
ALP
DEXA scan
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13
Q

What should prompt bone protection treatment

A

Fragility fracture in >75 year old needs treatment.

Investigation not necessary.

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14
Q

Management of osteoporosis

A
Smoking cessation
Reduce alcohol intake 
Exercise
Sun exposure 
Adcal D3
Bisphosphonates (alendronate or risedronate) 
Consider HRT for post menopausal women 
\+/- falls risk assessment
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15
Q

Advice for taking a bisphosphonate

A

Must be taken on empty stomach
Take 30 mins before breakfast with water only
Stay upright for at least 30 mins
Weekly dose
Don’t take iron or calcium supplements for at least 30 mins

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16
Q

Complications and side effects of bisphosphonate therapy

A
Complications:
Jaw osteonecrosis 
Atypical fractures
Peptic ulcers
Oesophagitis
Side effects:
Nausea
Epigastric pain
Muscle pain
Joint pain
Bone pain