Osteoporosis Patient Assessment Flashcards
(16 cards)
What is the clinical presentation of osteoporosis?
-pain
-immobility
-depression
-shortened stature (loss of >1.5 inches from tallest recorded height)
-kyphosis/lordosis
-fracture
-low BMD
Which biochemical markers of bone turnover (BTMs) are markers of bone resorption?
-CTX
-NTX
Which BTMs are markers of bone formation?
-BSAP: serum bone specific alkaline phosphatase
-OC: osteocalcin
-P1NP
Which diagnostic test for osteoporosis is the most precise?
DXA
Who should have a BMD test?
- women ≥ 65, men ≥70
- younger postmenopausal women or men with risk factors
- postmenopausal women or men ≥50 with history of fracture
- adults with a condition or taking med associated with low BMD
What is T-score?
BMD compared to young “normal” adults of same gender
USED FOR DIAGNOSIS
What is Z-score?
BMD compared to expected BMD for patient’s age, gender, race/ethnicity
What is normal T-score?
within 1 SD: ≥ -1
What T-score is classified as osteopenia (low bone mass)?
between -1.0 and -2.5
What T-score is classified as osteoporosis?
≤ -2.5
What classifies a patient as having severe or established osteoporosis?
T-score ≤ -2.5 WITH one or more fractures
According to AACE/ACE, what is the diagnostic criteria for osteoporosis?
- T-score ≤ -2.5 in LUMBAR, FEMORAL NECK, OR RADIUS
- low-trauma SPINE OR HIP fracture (regardless of BMD)
- osteopenia AND a fragility fracture of PROMIXMAL HUMERUS, PELVIS, OR DISTAL ARM
- osteopenia AND high FRAX fracture probability
What 10-year probability of HIP fracture is considered high risk?
≥ 3%
What 10-year probability of major OP fracture is considered high risk?
≥ 20%
What are the risk factors in WHO model (FRAX)?
-gender (female)
-race/ethnicity
-alcohol intake
-smoking
-age
-low BMI
-prior OP fracture
-oral glucocorticoids
-RA
-secondary OP
-parental hx of hip fracture
