A 70-year-old African-American male is brought to the emergency department with a low-trauma hip fracture. His past medical history is significant for long-term hypertension and myocardial infarction experienced two years ago. His current medications include metoprolol, enalapril, hydrochlorothiazide, and aspirin. He smokes two packs of cigarettes daily, and consumes alcohol occasionally. His mother had a vertebral fracture "when she was old." His serum calcium, phosphate, and alkaline phosphatase levels are normal. An x-ray of the hip shows osteopenia and a hip fracture. Which of the following is the single most important risk factor for this patient's condition?

Question

A 70-year-old African-American male is brought to the emergency department with a low-trauma hip fracture.  His past medical history is significant for long-term hypertension and myocardial infarction experienced two years ago.  His current medications include metoprolol, enalapril, hydrochlorothiazide, and aspirin.  He smokes two packs of cigarettes daily, and consumes alcohol occasionally.  His mother had a vertebral fracture "when she was old."  His serum calcium, phosphate, and alkaline phosphatase levels are normal. An x-ray of the hip shows osteopenia and a hip fracture. Which of the following is the single most important risk factor for this patient's condition?

Quizplus · Accepted Answer

Explanation: While less common in men than in women, osteoporosis is associated with significant morbidity. It is estimated that a 60-year-old male has a 25% chance of suffering an osteoporotic fracture. Bone mineral density depends on peak bone mass and the rate of bone mass loss. The peak bone mass is higher in men than in women; therefore, the former present with osteoporotic fractures approximately ten years later than women. The rate of bone mineral content loss after 30 years of age is approximately 0.5 - 1% per year. Age is the most important single risk factor for osteoporosis and osteoporotic bone fracture. (Choices F, D and E)Other contributing factors such as family history, smoking, and alcohol consumption are also important. (Choice C)The medications which predispose a patient to have osteoporosis include: glucocorticoids, anti-androgens, and some anticonvulsants. (Choice B)Caucasian males are more susceptible to osteoporosis than African-Americans. Educational Objective: Age is the most important single risk factor for osteoporosis and osteoporotic bone fracture.

A 70-Year-Old African-American Male Is Brought to the Emergency Department