Exam 2 - Bone health and osteoporosis

Question 1

At what age range does bone development peak?

Answer 1

Ages 18-25 years

Question 2

Osteoporosis risk factors

Answer 2

• Advanced age (>65 years)
• History of fracture without substantial trauma as an adult
• Family history
• Female gender
• Late menarche (>15 years) or early menopause (<45 years)
• Smoker
• BMI <20 or <127 pounds
• Nulliparity
• Eating disorder, exercise induced amenorrhea
• Chronic steroid use for more than 3-6 months
• Inadequate vitamin D or calium
• Chronic illness (arthritis, hyperparathyroidism, impaired absorption syndrome, autoimmune disoder)
• Heavy alcohol use
• Medications - anticonvulsants, steroids, anticoagulants, Depo, tamoxifen, SSRIs, PPIs

Question 3

Osteoporosis screening recommendations

Answer 3

• All women aged 65+ regardless of risk factors

Question 4

What three diagnostic tests are used to diagnose osteoporosis?

Answer 4

• DEXA scan (bone mineral density)
• Z score
• FRAX (fracture risk assessment tool)

Question 5

DEXA scan - what are the ranges for normal, osteopenia, and osteoporosis?

Answer 5

Normal: -1 to 0 SD

Osteopenia: -2.5 to -1 SD

Osteoporosis: less than -2.5 SD

Question 6

What does the Z score indicate when diagnosing osteoporosis?

Answer 6

Compares reference population of same age, gender, ethnicity

• Used mostly for children, teens, young adults

Question 7

What does the FRAX tool indicated when screening for osteoporosis?

Answer 7

Estimation of risk for major osteopenia fracture in the next 10 years

• Intended for postmenopausal women