CME Osteoporosis

All of the following are risk factors for osteoporosis EXCEPT:

• Low calcium intake

• Smoking

• Alcohol use

• Obesity

Answer explanation

Obesity is not a risk factor for osteoporosis; in fact, it may provide some protection due to increased bone density. In contrast, low calcium intake, smoking, and alcohol use are known risk factors.

Which of the following medical conditions or medications can lead to secondary osteoporosis?

• Hypothyroidism

• Long term corticosteroids

• Type 2 DM

• Angiotensin-converting enzyme (ACE)

  inhibitors

Answer explanation

Long term corticosteroids are known to cause secondary osteoporosis by inhibiting bone formation and increasing bone resorption, leading to decreased bone density. The other options do not have a direct link to secondary osteoporosis.

A 65-year-old woman presents for interpretation of BMD testing. Her personal medical history is unremarkable, but her mother died at age 75 years due to complications of a hip fracture. Her T score is –2. Which of the following choices is the correct interpretation of this patient’s T score and treatment?

• Normal BMD; calcium supplementation

• Normal BMD; alendronate for prevention

• Osteopenia; alendronate for treatment

• Osteoporosis; alendronate for treatment

Answer explanation

The patient's T score of -2 indicates osteopenia. Given her age and family history of hip fracture, alendronate is appropriate for treatment to reduce fracture risk.

A 50-year-old woman visits your clinic for an annual examination. She takes inhaled steroids and β-agonists for mild intermittent asthma. Her past medical history is negative for any fracture. She has no family history of osteoporosis. She exercises regularly. Her menses are regular. Based on her history, what are your recommendations for osteoporosis prevention and screening?

• Vitamin D and calcium supplementation

• Bone mineral density (BMD) screening

• Begin alendronate therapy to increase bone density

• x-ray of her hips and lumbar spine

Answer explanation

Given her age and risk factors, recommending vitamin D and calcium supplementation is appropriate for osteoporosis prevention. She does not require BMD screening or medication like alendronate at this time.

All of this is common sites of fracture for osteoporosis patient, except :

• Spine

• Ankle

• Wrist

• Hip

Answer explanation

The rib is not a common site of fracture for osteoporosis patients. The spine, wrist, and hip are typical fracture sites due to the weakened bone structure associated with osteoporosis.

All this is type of Primary Osteoporosis, except :

• Postmenopausal osteoporosis

• Age-related osteoporosis

• Idiopathic osteoporosis

• Osteogenesis Imperfecta

Answer explanation

Osteogenesis Imperfecta is a genetic disorder affecting collagen production, leading to brittle bones, and is not classified as primary osteoporosis, unlike the other types listed.

Diagnosis of osteoporosis can be made after :

• Low impact hip or spine fracture

• Chronic back pain that not resolved

• Postmenopausal

• BMD result of -1

Which of the following lifestyle changes can help reduce the risk of osteoporosis?

• Increased physical activity

• High protein diet

• Excessive caffeine consumption

• Prolonged bed rest

What is the primary purpose of a bone mineral density (BMD) test?

• To assess bone strength

• To evaluate joint health

• To diagnose fractures

• To measure calcium levels

Which of the following is NOT a common symptom of osteoporosis?

• Back pain

• Height loss

• Joint swelling

• Fractures from minor falls