Year 3 > Osteoporosis > Flashcards

Osteoporosis Flashcards

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1
Q

What is osteoporosis?

A

A state of low bone density with structural deterioration of bones, increasing the risk of fragility fractures.

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2
Q

How is osteoporosis diagnosed?

A

Patients are diagnosed if their bone mineral density (BMD) is at least 2.5 standard deviations below the mean peak mass of young healthy adults, measured with a DEXA scan.

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3
Q

What is the significance of a T-score of -2.5?

A

A T-score of -2.5 or less is considered diagnostic of osteoporosis.

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4
Q

What is osteopenia?

A

A T-score between -1 and -2.5.

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5
Q

Which populations are at higher risk for osteoporosis?

A
  • Post-menopausal women
  • Older adults
  • Individuals of white ethnicity
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6
Q

List risk factors for osteoporosis that reduce bone density.

A
  • Low BMI
  • Menopause
  • Immobility
  • Chronic diseases (e.g., liver disease, COPD)
  • Malabsorption diseases
  • Endocrine diseases (e.g., hyperparathyroidism)
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7
Q

What medications can reduce bone density?

A
  • Proton Pump Inhibitors (PPIs)
  • Selective Serotonin Reuptake Inhibitors (SSRIs)
  • Carbamazepine
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8
Q

List risk factors for osteoporosis that do not reduce bone density.

A
  • Older age
  • Inflammatory arthritis
  • Prolonged use of steroids
  • Smoking
  • Alcohol excess
  • History of fragility fracture
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9
Q

What are the most common fragility fractures?

A
  • Vertebral body
  • Neck of femur (hip)
  • Distal radius
  • Proximal humerus
  • Pelvis
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10
Q

What are common symptoms of fragility fractures?

A
  • Acute severe pain
  • Difficulty weight-bearing
  • Difficulty mobilising
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11
Q

What does a Z-score indicate?

A

It compares bone density to an age, sex, and ethnicity matched population.

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12
Q

When should a DEXA scan be offered?

A
  • Aged over 50 with a fragility fracture
  • Aged under 40 with a major risk factor for fragility fracture
  • Those about to start treatment that will rapidly decrease bone density
  • All other patients with risk factors should have their fracture risk assessed.
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13
Q

What is the role of vitamin D in osteoporosis management?

A

Prescribing vitamin D supplementation for patients not exposed to adequate sunlight.

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14
Q

What is the first-line treatment for osteoporosis?

A

Oral bisphosphonates, such as alendronate and risedronate.

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15
Q

How should oral bisphosphonates be taken?

A

On an empty stomach, at least 30 minutes before food or other medications, and the patient should remain upright for at least 30 minutes after taking them.

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16
Q

What are common side effects of bisphosphonates?

A
  • Nausea
  • Dyspepsia
  • Gastritis
  • Abdominal pain
  • Musculoskeletal pains
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17
Q

What are rarer side effects of bisphosphonates?

A
  • Oesophagitis
  • Osteonecrosis of the jaw
  • Atypical stress fractures
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18
Q

What contraindications exist for bisphosphonate use?

A
  • Severe chronic kidney disease
  • Hypocalcaemia
  • Oesophageal abnormalities
  • Recent peptic ulceration
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19
Q

If oral bisphosphonates are not tolerated, what are alternative treatments?

A
  • Parenteral bisphosphonates (e.g., zoledronate)
  • Denosumab
  • Raloxifene hydrochloride
  • Strontium ranelate
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20
Q

What is the role of hormone replacement therapy in osteoporosis?

A

It should be considered for younger women experiencing menopausal symptoms, as it reduces fragility fracture risk.

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21
Q

What treatments may be recommended first-line for women with severe osteoporosis?

A
  • Teriparatide
  • Romosozumab
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22
Q

What is osteoporosis?

A

A state of low bone density with structural deterioration of bones, increasing the risk of fragility fractures.

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22
Q

What is osteoporosis?

A

A state of low bone density with structural deterioration of bones, increasing the risk of fragility fractures.

How well did you know this?
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23
Q

How is osteoporosis diagnosed?

A

Patients are diagnosed if their bone mineral density (BMD) is at least 2.5 standard deviations below the mean peak mass of young healthy adults, measured with a DEXA scan.

How well did you know this?
1
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3
4
5
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23
How is osteoporosis diagnosed?
Patients are diagnosed if their bone mineral density (BMD) is at least 2.5 standard deviations below the mean peak mass of young healthy adults, measured with a DEXA scan.
24
What is the significance of a T-score of -2.5?
A T-score of -2.5 or less is considered diagnostic of osteoporosis.
24
What is the significance of a T-score of -2.5?
A T-score of -2.5 or less is considered diagnostic of osteoporosis.
25
What is osteopenia?
A T-score between -1 and -2.5.
25
What is osteopenia?
A T-score between -1 and -2.5.
26
Which populations are at higher risk for osteoporosis?
* Post-menopausal women * Older adults * Individuals of white ethnicity
26
Which populations are at higher risk for osteoporosis?
* Post-menopausal women * Older adults * Individuals of white ethnicity
27
List risk factors for osteoporosis that reduce bone density.
* Low BMI * Menopause * Immobility * Chronic diseases (e.g., liver disease, COPD) * Malabsorption diseases * Endocrine diseases (e.g., hyperparathyroidism)
27
List risk factors for osteoporosis that reduce bone density.
* Low BMI * Menopause * Immobility * Chronic diseases (e.g., liver disease, COPD) * Malabsorption diseases * Endocrine diseases (e.g., hyperparathyroidism)
28
What medications can reduce bone density?
* Proton Pump Inhibitors (PPIs) * Selective Serotonin Reuptake Inhibitors (SSRIs) * Carbamazepine
28
What medications can reduce bone density?
* Proton Pump Inhibitors (PPIs) * Selective Serotonin Reuptake Inhibitors (SSRIs) * Carbamazepine
29
List risk factors for osteoporosis that do not reduce bone density.
* Older age * Inflammatory arthritis * Prolonged use of steroids * Smoking * Alcohol excess * History of fragility fracture
29
List risk factors for osteoporosis that do not reduce bone density.
* Older age * Inflammatory arthritis * Prolonged use of steroids * Smoking * Alcohol excess * History of fragility fracture
30
What are the most common fragility fractures?
* Vertebral body * Neck of femur (hip) * Distal radius * Proximal humerus * Pelvis
30
What are the most common fragility fractures?
* Vertebral body * Neck of femur (hip) * Distal radius * Proximal humerus * Pelvis
31
What are common symptoms of fragility fractures?
* Acute severe pain * Difficulty weight-bearing * Difficulty mobilising
31
What are common symptoms of fragility fractures?
* Acute severe pain * Difficulty weight-bearing * Difficulty mobilising
32
What does a Z-score indicate?
It compares bone density to an age, sex, and ethnicity matched population.
32
What does a Z-score indicate?
It compares bone density to an age, sex, and ethnicity matched population.
33
When should a DEXA scan be offered?
* Aged over 50 with a fragility fracture * Aged under 40 with a major risk factor for fragility fracture * Those about to start treatment that will rapidly decrease bone density * All other patients with risk factors should have their fracture risk assessed.
33
When should a DEXA scan be offered?
* Aged over 50 with a fragility fracture * Aged under 40 with a major risk factor for fragility fracture * Those about to start treatment that will rapidly decrease bone density * All other patients with risk factors should have their fracture risk assessed.
34
What is the role of vitamin D in osteoporosis management?
Prescribing vitamin D supplementation for patients not exposed to adequate sunlight.
34
What is the role of vitamin D in osteoporosis management?
Prescribing vitamin D supplementation for patients not exposed to adequate sunlight.
35
What is the first-line treatment for osteoporosis?
Oral bisphosphonates, such as alendronate and risedronate.
35
What is the first-line treatment for osteoporosis?
Oral bisphosphonates, such as alendronate and risedronate.
36
How should oral bisphosphonates be taken?
On an empty stomach, at least 30 minutes before food or other medications, and the patient should remain upright for at least 30 minutes after taking them.
36
How should oral bisphosphonates be taken?
On an empty stomach, at least 30 minutes before food or other medications, and the patient should remain upright for at least 30 minutes after taking them.
37
What are common side effects of bisphosphonates?
* Nausea * Dyspepsia * Gastritis * Abdominal pain * Musculoskeletal pains
37
What are common side effects of bisphosphonates?
* Nausea * Dyspepsia * Gastritis * Abdominal pain * Musculoskeletal pains
38
What are rarer side effects of bisphosphonates?
* Oesophagitis * Osteonecrosis of the jaw * Atypical stress fractures
38
What are rarer side effects of bisphosphonates?
* Oesophagitis * Osteonecrosis of the jaw * Atypical stress fractures
39
What contraindications exist for bisphosphonate use?
* Severe chronic kidney disease * Hypocalcaemia * Oesophageal abnormalities * Recent peptic ulceration
39
What contraindications exist for bisphosphonate use?
* Severe chronic kidney disease * Hypocalcaemia * Oesophageal abnormalities * Recent peptic ulceration
40
If oral bisphosphonates are not tolerated, what are alternative treatments?
* Parenteral bisphosphonates (e.g., zoledronate) * Denosumab * Raloxifene hydrochloride * Strontium ranelate
40
If oral bisphosphonates are not tolerated, what are alternative treatments?
* Parenteral bisphosphonates (e.g., zoledronate) * Denosumab * Raloxifene hydrochloride * Strontium ranelate
41
What is the role of hormone replacement therapy in osteoporosis?
It should be considered for younger women experiencing menopausal symptoms, as it reduces fragility fracture risk.
41
What is the role of hormone replacement therapy in osteoporosis?
It should be considered for younger women experiencing menopausal symptoms, as it reduces fragility fracture risk.
42
What treatments may be recommended first-line for women with severe osteoporosis?
* Teriparatide * Romosozumab
42
What treatments may be recommended first-line for women with severe osteoporosis?
* Teriparatide * Romosozumab
43
When is alendronic acid indicated?
Alendronic acid. They should be started in women with either confirmed osteoporosis by DEXA scanning or >75 years with two or more risk factors for fracture or a previous fragility fracture
44
What can be offered to those with poor response to bisphopsohanate?
Teriparatide, a parathyoirid hormone recombinant treatment
45
What is raloxifene?
This naturally mimics the effects of oestrogen helping to protect the bone that is excessively broken down after menopause. Given this there is a risk of developing deep vein thrombosis they are however a good option in patients with strong family history of breast cancer as they can reduce the risk of this Useful in span disease
46
What are the side effects of alendronic acid?
Side effects include severe reflux disease and peptic ulceration, necrosis of the jaw(a rare complication) and should be avoided in advanced kidney disease
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