Geris

Question 1

Osteoporosis Mx

Answer 1

• Smoking, alcohol, weight
• Reduce steroids
• ? Calcium Vit D
• Bisphosphonates - alendronic acid & risedronate
• or Denosumab if intolerant
• HRT if young menopausal

Question 2

Diagnosis of osteoporosis

Answer 2

DEXA scan T-score of −2.5

Question 3

Secondary causes of osteoporosis

Answer 3

RA and other inflammatory arthropathies. (Rheumatoid arthritis also increases risk of fracture independently of BMD and use of steroids.)
 immobilisation or sedentary lifestyle.
Primary hypogonadism (men and women).
Primary hyperparathyroidism.
Hyperthyroidism
Post-transplant
CKD
IBD, coeliac disease.
Untreated premature menopause (<45 years) or prolonged secondary amenorrhoea.
T1 or 2 DM
Chronic liver disease.
COPD