Practice this case based on how you are assessed in your OSCEs, and use the relevant sections for general revision. 🤓
Doctor Instruction:
You are a Junior Doctor working in General Practice. Your next patient is Margaret Choy – a 65-year-old woman coming in to discuss her recent DEXA scan, which confirmed osteoporosis. Please take a short history, discuss with the patient about her management plan, and answer any questions she or the examiner may have.
Patient History:
Margaret Choy, a 65-year-old female- retired. Height 168cm 50kg BMI 17.7 kg/m².
You had your DEXA scan at the hospital last week, due to having a medium level “FRAX Score”. You feel well otherwise—no particular symptoms. You have a good, well-balanced diet. You are currently in post-menopause for over ten years. No previous fractures.
Ideas, Concerns & Expectations:
You have no idea what osteoporosis/bone thinning means, but you would like more about this. You are concerned about the risk of fractures. You would like to know more about what you can do to prevent fractures and the overall management of osteoporosis.
Past Medical History:
Gastric reflux
COPD
Osteoarthritis
No history of falls or fractures
Drug History:
Omeprazole
Anoro Ellipta inhaler
Allergic to fish - rash.
Family History:
Hip fracture and osteoporosis from mother
Social History:
Smoke ten cigarettes/day for 30 years
Drink a glass of white wine every week
Live with husband in a bungalow
Independent at home
Viva Questions from patient or examiner:
1. What is osteoporosis vs osteopenia?
Osteoporosis is a condition with reduced density of the bones. Osteopenia is a less severe reduction in bone density. Reduced bone density makes the bone more brittle, less strong, and prone to fractures.