Other endocrine Flashcards
(13 cards)
Describe the T scores and what do they mean for osteoporosis?
Normal = above -1
Osteopenia= between -1 and -2.5
Osteoporosis= -2.5 or less
Established osteoporosis= -2.5 or less and a fracture
Is an X-ray a good diagnostic factor to use in osteoporosis and why?
No, it is not capable of detecting bone loss until at least 30% of bone mass is lost
What is used to measure BMD?
Dual Energy Xray Absorptiometry (DEXA) scan is used
Enables accurate and reproducible measurements of BMD, but is expensive
What is fragility fracture in osteoporosis?
Fracture that occurs as a result of mechanical forces that would not ordinarily cause fracture
WHO quantifies this as a force equivalent to a fall at standing height or less
What are the symptoms due to fractures of osteoporosis?
Can gradually cause the spine to collapse, resulting in height loss, pain and a deformed back
Forward curvature= kyphosis
Which patients should receive osteoporosis prophylaxis when taking glucocorticoids?
Anyone with prior fragility fracture
Women 70 or above
Post menopausal women and men 50 or above prescribed high dose steroids i.e 7.5mg/day of prednisolone or equivalent over 3 months or more than 30mg day for 4 weeks
Post menopausal women and men aged 50 or above with a high risk FRAX score
What is the treatment for low risk patients for osteoporosis?
Lifestyle + calcium/vitD
What is the treatment for intermediate risk patients of osteoporosis:
Assess BMD with DEXA scan + lifestyle+ calcium/vitD
What is the treatment for high risk patients?
Consider starting treatment without need for BMD assessment
What should be given to all patients in a nursing home?
Vitamin D supplement
Including people who are house bound
What is the first line drug treatment for osteoporosis and describe:
Bisphosphonates
Alendronic acid (daily or weekly)
Risedronate (daily or weekly)
Ibandronate (oral monthly, IV 3 monthly)
Zolendronate (annual IV)
When should you review the BMD when taking bisphosphonates?
Oral treatment: after 5 years
IV treatment after 3 years
What is the patient counselling for bisphosphonates?
Take on an empty stomach (at least 30 mins (60 mins for ibandronate) before breakfast and any other oral medications including calcium supplements- wait 2 hours to take these)
Swallow whole with a full glass of PLAIN water
Take whilst sitting upright or standing
Remain upright for at least 30 mins (60 mins for ibandronate)
Dont lie down until after eating breakfast
Dont take at bedtime or before rising
Stop treatment and report any signs of oesophageal irritation
If pt can’t adhere to these then should be considered for IV therapy
