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Questions and Answers
What is the primary purpose of DEXA scans?
What is the primary purpose of DEXA scans?
Which score requires evaluation for secondary osteoporosis when it is less than -2.0?
Which score requires evaluation for secondary osteoporosis when it is less than -2.0?
What does a more negative T Score indicate?
What does a more negative T Score indicate?
Which of the following is NOT a component considered by the FRAX Score?
Which of the following is NOT a component considered by the FRAX Score?
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Which markers can indicate bone repair or damage?
Which markers can indicate bone repair or damage?
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What role do biochemical markers play in fracture risk assessment?
What role do biochemical markers play in fracture risk assessment?
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Which of the following conditions is associated with secondary osteoporosis?
Which of the following conditions is associated with secondary osteoporosis?
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Why might biochemical markers for bone turnover not be utilized?
Why might biochemical markers for bone turnover not be utilized?
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Study Notes
DEXA Overview
- DEXA stands for Dual-Energy X-ray Absorptiometry, a standard method for assessing bone mineral density (BMD).
- Primarily used to diagnose osteoporosis and evaluate fracture risk by measuring bone mineral content, especially in the hip and spine.
- The procedure involves low-dose X-ray technology and is recognized as safe and non-invasive.
- DEXA results are presented as T-scores (comparison with healthy young adults) and Z-scores (comparison with peers of the same age and sex).
Interpreting DEXA Scores
- T Score: Represents the difference in bone density compared to a healthy young adult; more negative values indicate a higher risk of fractures.
- Z Score: Indicates how a person’s bone density compares to same-age and same-sex individuals; Z-score below -2.0 suggests the need to investigate secondary osteoporosis.
- FRAX Score: Utilizes the WHO Fracture Risk Assessment Tool incorporating factors like age, sex, body metrics, past fractures, and lifestyle factors to estimate fracture risk.
Alternative Imaging Modalities
- Methods such as whole body DEXA, quantitative CT, and ultrasound of the calcaneus are available for specialized cases but may be less commonly referenced.
Screening for Secondary Osteoporosis
- Conditions that may lead to secondary osteoporosis include:
- Hyperparathyroidism
- Chronic kidney disease
- Hematologic cancers (multiple myeloma, leukemia, lymphoma)
- Hyperthyroidism
Biochemical Markers for Bone Turnover
- Key indicators of bone health include:
- Serum C-telopeptide (CTX)
- Urinary N-telopeptide (NTX)
- Alkaline phosphatase
- Osteocalcin
- These markers signal bone repair processes and can identify micro-fractures.
Role of Biochemical Markers
- Useful for fracture risk prediction, providing insight beyond BMD measures.
- Assist in monitoring therapy responses within months after treatment initiation.
- Recommended for patients with borderline bone density or those starting pharmacological treatments.
Practical Considerations
- Coverage for biochemical markers may vary with insurance policies, affecting accessibility for patients.
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Description
This quiz covers the fundamentals of DEXA (Dual-Energy X-ray Absorptiometry) and its role in diagnosing osteoporosis. Discover how DEXA scans measure bone mineral density (BMD) and assess fracture risk. Learn about T-scores and Z-scores that provide insights into bone health.
