osteoporosis

Question 1

define osteoporosis?

Answer 1

reduced bone density defined as > 2.5 standard deviations below peak bone mass achieved by healthy adults

Question 2

what are the major risk factors for osteoporosis?

Answer 2

o	Age  
o	Females 
o	Corticosteroid use 
o	Rheumatoid arthritis 
o	Alcohol excess 
o	History of hip fracture 
o	Low body mass index 
o	Smoking

Question 3

what are other causes of osteoporosis?

Answer 3

o	Premature menopause 
o	Sedentary lifestyle 
o	Malignancy 
•	Myeloma
•	metastatic carcinoma  
o	Endocrine: 
•	Cushing's disease  
•	Thyrotoxicosis 
•	Primary hyperparathyroidism 
•	Hypogonadism 
o	Gastrointestinal: 
•	Malabsorption (e.g. coeliac disease, partial gastrectomy) 
•	Liver disease (e.g. primary biliary cirrhosis)  
•	Anorexia 
o	Chronic kidney disease
o	Osteogenesis imperfecta

Question 4

what is the epidemiology of osteoporosis?

Answer 4

• COMMON in females

* More common in CAUCASIANS and ASIANS than Afro-Caribbean’s

Question 5

which fractures are common in osteoporosis?

Answer 5

o Neck of femur
o Vertebral fractures
o Colles’ fracture

Question 6

what position suggests a NOF fracture?

Answer 6

o Severe pain when hip flexed and externally rotated

Question 7

what tool can be used to risk assess a osteoporosis patient?

when should one act upon the FRAX score?

Answer 7

FRAX score

if it is greater than 10%

Question 8

which bloods should be done for osteoporosis?

Answer 8

o Calcium
o Phosphate
o ALP
o PTH

Question 9

what are the bloods in primary osteoporosis?

Answer 9

normal

Question 10

what is the T score?

Answer 10

the number of standards deviations the bone mineral density measurement is above or below the young normal mean bone mineral density

Question 11

what is a normal and abnormal T score?

Answer 11

• > -1 is normal
• -1 to - 2.5 = osteopenia
• <2.5 = osteoporosis

Question 12

what does a z score factor in?

Answer 12

age, gender and ethnic factors.