Discuss the basic epidemiology, pathophysiology, presentation, investigation, management and prognosis of osteopenia & osteoporosis

Question 1

What does the FRAX tool assess?

Answer 1

estimates a patient’s 10 year risk of osteoporotic fracture

Question 2

What is the prognosis for osteoporosis?

Answer 2

good if bone loss is detected early and proper intervention is undertaken

Question 3

What medications can prevent osteoporosis in post-menopausal women?

Answer 3

HRT or raloxifene

Question 4

What is the first line medication prescribed to patients with osteoporosis?

Answer 4

Bisphosphonates (Alendronate)

Question 5

What is primary osteoporosis?

Answer 5

idiopathic and age related

Question 6

How does osteoporosis present?

Answer 6

• pain
• deformity
• immobility due to fractures
• detected by screening measurements

Question 7

What 5 lifestyle measures can be taken to manage osteoporosis?

Answer 7

1. quit smoking
2. reduce animal consumption
3. weight bearing exercise to increase bone mineral density
4. balance exercises and fall prevention programmes
5. calcium and vitamin D rich diet/supplements

Question 8

What does a DEXA (Dual-energy X-ray absorptiometry) scan measure?

Answer 8

bone mineral density

Question 9

What two pharmacological alternatives are there for patients that do not tolerate bisphosphonates?

Answer 9

1. Strontium ranelate
2. denosumab

Question 10

True or false?

Osteopenia does not always lead to osteoporosis?

Answer 10

true

Question 11

What is secondary osteoporosis and give 6 examples

Answer 11

• osteoporosis resulting from another disease process

1. rheumatoid arthritis
2. IBD
3. anorexia nervosa
4. hyperparathyroidism
5. hyperthyroidism
6. drugs

Question 12

What will the blood results for a patient presenting with osteoporosis show?

Answer 12

• normal calcium
• normal phosphate
• normal alkaline phosphate

Question 13

What is osteoporosis?

Answer 13

weakness in bones, due to below normal bone mass or above normal bone loss

Question 14

What is the bone mineral density T-score for osteoporosis?

Answer 14

< -2.5

Question 15

Who are more at risk of acquiring osteoporosis? (3)

Answer 15

• post menopausal women
• steroid users
• low body mass

Question 16

What is the pathophysiology behind osteoporosis?

Answer 16

• bone loss is accelerated in osteoporosis
• by an imbalance between the rates of bone reabsorption and formation
• which are governed by the osteoclasts and osteoblasts respectively

Question 17

What is the T-score for normal bone mineral density?

Answer 17

≥-1

Question 18

What does DEXA stand for?

Answer 18

Dual-energy X-ray absorptiometry

Question 19

What is denosumab?

Answer 19

monoclonal antibodies directed against RANK-L to treat osteoporosis

Question 20

What is the bone mineral density T-score for osteopenia?

Answer 20

-1 to -2.5