Osteoporosis Flashcards

(29 cards)

1
Q

What are the two unique characteristics of osteoporosis

A

Low bone density and micro-architectural defects in bone tissue

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2
Q

What is th result of low bone density and micro-architectural defects in bone tissue

[characteristics of osteoporosis]

A

Increased bone fragility and susceptibility to fragility fractures

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3
Q

Define osteopenia

A

Less severe reduction in bone density than osteoporosis (-1 to -2.5 T score)

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4
Q

Define fragility fracture

A

A fracture following a fall from standing height or less

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5
Q

What are the two main risk factors for osteoporosis

A

Age and female sex

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6
Q

Age is a risk factor for osteoporosis, but it is different between genders.

What age is a risk factor for males and females

A

> 50 for women

> 65 for men

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7
Q

Age and female gender is the two main risk factors for osteoporosis.

Name furthur risk factors

A

“SHATTERED FAMILY”

S – Steroid use

H – Hyperthyroidism, hyperparathyroidism

A – Alcohol and smoking

T – Thin (low BMI)

T – Testosterone deficiency

E – Early menopause

R – Renal/liver failure

E – Erosive/inflammatory bone disease

D – Diabetes

Family history

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8
Q

What are the clinical features of osteoporosis

A

With the exception of fracture, osteoporosis is an asymptomatic condition.

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9
Q

What are the 3 most common places to get a fragility fracture

A

Wrist

Spine

Hip

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10
Q

What is FRAX or QFracture

A

Screening tool for osteoporosis

Assesses the 10-year risk of a patient developing a fragility fracture

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11
Q

What is the name of the screening tool used in osteoporosis to assess the 10-year risk of a patient developing a fragility fracture

A

FRAX or QFracture

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12
Q

FRAX or QFracture is the screening tool used in osteoporosis to assess the 10-year risk of a patient developing a fragility fracture. It categories patients into three groups based on their risk.

Name these groups

A

high, intermediate and low risk

The scan is not mandatory and clinicians may proceed straight to DXA scan

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13
Q

What is the gold standard investigation used in osteoporosis

A

DXA scan (dual energy x-ray absorptiometry)

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14
Q

What is a DXA scan

A

X-ray scan used to measure bone mineral density

Gold standard investigation for osteoporosis/osteopenia

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15
Q

DXA Scan is used at the gold standard investigation for osteoporosis. Where in the body is it usually done on?

A

Hip

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16
Q

DXA Scan is used at the gold standard investigation for osteoporosis. The result is represented as a T score.

What is the T score

A

The number of standard deviations below the mean for a healthy young adult their bone density is

17
Q

DXA scan is used as the gold standard investigation for osteoporosis.

What is the T score for osteoporosis

18
Q

DXA scan is used as the gold standard investigation for osteoporosis.

What is the T score for osteopenia

A

Between -1 and -2.5

19
Q

What is the goal of osteoporosis management

A

Preventation of fragility fractures

20
Q

Osteoporosis managed with a combination of lifestyle changes and pharmacological treatment.

Name some lifestyle changes

A

Adequate calcium and vitamin D intake (can be given supplementation)

Weight-bearing exercise to maintain bone strength

21
Q

Osteoporosis managed with a combination of lifestyle changes and pharmacological treatment.

What is the 1st line pharmacological used in osteoporosis management

A

Oral Bisphosphonates

22
Q

Oral bisphosphonates is the 1st line pharmacological used in osteoporosis management.

Describe bisphosphonates mechanism of action

A

Interfere with osteoclasts reducing their activity and thus inhibits bone resorption

23
Q

Oral bisphosphonates is the 1st line pharmacological used in osteoporosis management.

Name some side effects of bisphosphonates

A

GI disturbance

Oesophagitis

Atypical femoral fractures

24
Q

Osteoporosis managed with a combination of lifestyle changes and pharmacological treatment.

What is the 2nd line pharmacological used in osteoporosis management

25
Denosumab is the 2nd line pharmacological used in osteoporosis management. Describe denosumab mechanism of action
Monoclonal antibody that blocks the activity of osteoclasts
26
Denosumab is the 2nd line pharmacological used in osteoporosis management. Name a side effect of denosumab
Cellulitis
27
Oral bisphosphonates and denosumab are the 1st and 2nd line therapy in the pharmacological management of osteoporosis. What other drugs can be used
Raloxifene Hormone replacement therapy (in women with premature menopause)
28
Raloxifene can be used as an additional therapy in managing osteoporosis. What is its mechanism of action
Binds to oestrogen receptors and exerts same protective action that oestrogen performs on bones by inhibiting osteoclastic action
29
Raloxifene is an additional therapy in the pharmacological management of osteoporosis. In what patient group is it most useful in
Post-menopausal women