3.       Osteoporosis is associated with:  

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MCQ Paper 1

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a. early menopause True
b.  obesity False
c.   long-term heparin therapy True
d. Turnerís syndrome True
e.  glucocorticoid therapy True
f. proton pump inhibitors False
g. poly-cystic ovary syndrome False
h. Fragile X carrier status True

Osteoporosis is associated with low oestrogen levels, hence its relationship with an early menopause and Turnerís syndrome.

Androgens are converted to oestrogen in fatty tissue, so obesity is protective.

Prolonged use of heparin is a known risk factor.

This applies to full-blown heparin, but not to the fractionated varieties, i.e. the low molecular weight ones.

Every medical student should know that long-term steroid use is a big risk factor for osteoporosis.

Proton pump inhibitors have been linked to atypical fractures of the neck of the femur.

Guisti et al. Bone. August 2010. Volume 47, Issue 2, Pages 169-180.

But this is fairly new and not yet recorded in the latest British National Formulary.

Anyway, the link is to atypical fractures of the neck of the femur, not osteoporosis.

Oestrogen levels are normal in polycystic ovary syndrome.

The absence of regular ovulation means that the beneficial effect of progesterone is diminished.

This means an association with endometrial cancer, but not osteoporosis.

See MCQ paper1, question13 and MCQ paper2, question 8.

Fragile X carriers have a 16% risk of premature ovarian failure, compared to 1% for the general population.

This increases their risk of osteoporosis.

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