Pathophysiology
This bone remodeling cell is responsible for breaking down bone and is overactive in osteoporosis.
What are osteoclasts?
Per USPSTF, all women of this age or older should be screened for osteoporosis with DXA.
What is 65 years?
A DXA T-score of –1.0 to –2.5 is consistent with this condition.
What is osteopenia?
This class of medications is first-line for most postmenopausal women with osteoporosis.
What are bisphosphonates?
This site is the most reliable for diagnosing osteoporosis and monitoring treatment response due to low variability.
What is femoral neck?
Most adults reach peak bone mass by this decade of life.
What is the 3rd decade (20s)?
USPSTF recommends screening younger postmenopausal women if their fracture risk is equal to or greater than that of a 65-year-old woman. This tool is used to calculate that risk.
What is the FRAX tool?
A T-score at or below this value confirms the diagnosis of osteoporosis.
What is -2.5?
This type of exercise is most effective at building and preserving bone density.
What is weight-bearing exercise?
After 5 years of this medication's use in stable, low-risk patients, many clinicians consider this management decision.
What is a bisphosphonate holiday?
Postmenopausal osteoporosis is primarily caused by the decline of this hormone, which normally inhibits bone resorption.
What is estrogen?
True or False: USPSTF recommends routine osteoporosis screening for men.
False
A patient with osteopenia may still be diagnosed with clinical osteoporosis if her FRAX 10-year fracture risk exceeds these thresholds for major osteoporotic fracture and hip fracture.
What are ≥20% major fracture or ≥3% hip fracture?
High alcohol consumption is associated with higher fracture risk. AAFP considers more than this many drinks per day to be high-risk.
What is >2 drinks/day?
The single most effective home modification to reduce hip fracture risk in older adults is elimination of this environmental hazard.
What are rugs?
Long-term use of this common medication class accelerates bone loss and increases fracture risk.
What are glucocorticoids?
Name two risk factors that would justify screening a postmenopausal woman under 65, according to USPSTF/AAFP risk-based recommendations.
What are low body weight, parental hip fracture, smoking, excessive alcohol, rheumatoid arthritis, or long-term steroid use?
A low-trauma fracture of the hip or vertebra is considered diagnostic of osteoporosis, meaning you can make the diagnosis even without abnormal results on this test.
What is a DXA Scan?
Patients at very high fracture risk (multiple fragility fractures or T-score < –3.5) may be treated with these anabolic agents.
What are teriparatide, abaloparatide, or romosozumab?
A compression fracture at this spinal region should prompt evaluation for malignancy rather than osteoporosis.
What is the upper thoracic spine?
This decoy receptor, secreted by osteoblasts, binds RANK-L and prevents osteoclast activation, thereby protecting bone density.
What is osteoprotegerin?
Low body weight is a key clinical risk factor when determining whether postmenopausal women younger than 65 should undergo DXA screening. In most models, this corresponds to a BMI below this threshold.
What is a BMI <21?
This score should be used to evaluate bone density in premenopausal women and men under 50.
What is the Z-score?
This medication is preferred in patients with osteoporosis who also have breast cancer risk, because it is both anti-resorptive and a selective estrogen receptor modulator.
What is raloxifene?
Excess consumption of this beverage type is associated with decreased bone mineral density.
What are colas?