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22 Cards in this Set
- Front
- Back
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What is the definition of osteoporosis?
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Compromised bone strength with increased risk of fracture
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What does bone strength reflect?
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1. bone density
2. bone quality |
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What is the ultimate goal in clinical Mx of osteoporosis?
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Prevent fragility fracture
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2 types of osteoporosis
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1 Primary osteoporosis
2. Secondary osteoporosis |
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2 types of primary osteoporosis
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1. post-menopausal
2. senile Is normal ageing process |
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What are the 3 independent risk factors for fragility fracture?
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1. low bone mineral density
2. advancing age 3. prior fracture |
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Complications of osteoporosis
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*** fracture
then 1. vertebral collapse 2. pain 3. psychosocial problem |
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In dual x-ray absorptiometry, what is t-score and z-score
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T-score: no. of SD below mean of young adult
Z-score: no. of SD below mean of age-matched normal |
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Practical use of T-score
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Indicative of bone strength
Normale: -1 < score < +1 Osteopenia: -2.5 <score < -1 Osteoporosis: score < -2.5 Sever osteoporosis: score < -2.5 + history of osteoporotic fracture |
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Practical use of Z-score
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Indicative for secondary osteoprosis
If score < -1 , beware of secondary osteoposis |
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Patient group of T-score and Z-score
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T -score : not pediatric patient
Z-score : can be pediatric patient |
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What is the only validated BMD measurement correlated with fracture risk?
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DXA ( Dual x-ray absorptiometry)
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Disadvantage of DXA
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1. affected by hyperostotic change in degenerative disease
2. results from different machine can not be directly compared |
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Is blood test useful in assess osteoporosis?
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No, blood test is not useful
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Mecial Tx for osteoporosis
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Inhibiting bone resorption
1. bisphosphonate 2. calcitonin (rarely use today) 3. SERMs Stimulating bone formation 1. PTH 2. Strontium Hormonal replacemnet therapy is no longer in use |
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Usage of bisphosphonate
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Taken with empty stomach and only with water
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Contraindication for bisphosphonate
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1. swallowing problem
2. severe renal impairment 3. GERD |
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What is the 1st line Tx drug?
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Bisphosphonate
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When is calcitonin used?
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acute vertebral fractures
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When is SERM used?
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Postmenopausal women at high risk of fracture
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What is the usage of teriparatide?
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Postmenopausal women and men with "severe osteoporosis"
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What is the usage of strontium
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An option for the treatment of osteoporosis
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