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28 Cards in this Set
- Front
- Back
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1. Interventions to reduce the risk of developing osteoporosis?
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1. Supplementation w/at least 1200 mg calcium per day
2. 400-800 IU vitamin D daily. 3. Regular weight-bearing exercise. |
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2. Women’s Health Initiative?
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a. An NIH sponsored research program to address the most common causes of morbidity and mortality in postmenopausal women.
b. This initiative included clinical trials of the effect of hormone therapy on the development of heart disease, fractures, and breast cancer. |
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3. Cardiovascular screening in women (#1 cause of death of women in the US)?
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3. Cardiovascular screening in women (#1 cause of death of women in the US)?
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4. Note: Recent studies have shown increased rates of adverse cardiovascular outcomes in women taking either oestrogen alone or combined oestrogen and progesterone. These risks include increased risk of CHD, stroke, and venous thromboembolic disease.
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4. Note: Recent studies have shown increased rates of adverse cardiovascular outcomes in women taking either oestrogen alone or combined oestrogen and progesterone. These risks include increased risk of CHD, stroke, and venous thromboembolic disease.
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5. Rec level for use of hormone replacement therapy for the prevention of chronic conditions?
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a. Level D: Not advised.
b. And any use of hormone replacement should be of the lowest effective dose for the shortest effective period |
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6. Risk factors for breast cancer?
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a. Increases w/age.
b. Having first child after 30. c. Family hx (particularly in mother or sister) d. Personal hx of breast cancer or atypical hyperplasia found on a previous breast biopsy e. Known carrier or Brca 1 or 2. |
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7. What has been shown to reduce mortality from breast cancer?
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a. Mammography screening every 12-33 months.
b. The benefits of routine mammographic screening increase w/age. |
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8. USPSTF recommendation for breast cancer screening
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a. Begins at age 40
b. Every 1-2 yrs. (level B rec). |
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9. High-risk HPV type?
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a. 16, 18, 45, 56.
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10. Risk factors for cervical cancer?
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a. Sexual intercourse w/multiple sexual partners
b. HPV c. Tobacco |
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11. Recommendation for cervical cancer screening?
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a. Start at age 21 or w/in 3 yrs of the onset of sexual activity, whichever comes first (level A rec).
b. Annual Pap smears until age 30 and then spacing out the interval to every 2 to 3 years |
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12. In whom do most cases of cervical cancer occur?
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a. In women who either have not been screened in over 5 years or did not have f/u after an abnormal pap.
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13. For whom does the USPSTF make recommend against pap smears(level D recommendation)?
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a. Women who have had a hysterectomy (including removal of the cervix) for benign indications.
b. Is to ask a woman < hysterectomy why the surgery was performed to confirm the absence of a cervix (either by reviewing the operative report or on examination) c. A woman who has had a hysterectomy for cancers indications falls out of the general screening parameters discussed here. |
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14. What is the optimal age to stop screening for cervical cancer?
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a. It is recommended to discontinue cervical cancer screening after the age of 65 both if no new risk factors have been identified (ie, new partner) and if there has been adequate recent screening (SPSTF).
b. American Cancer Society says to stop the age 70 if a woman has had 3 consecutive normal Pap smears and no abnormal Pap smears in the last 10 years. |
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15. How does the incidence of cervical cancer change with age?
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a. Incidence of cervical cancer falls with age
b. False-positive rate increases, thus potentially subjecting women to additional unnecessary procedures. |
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16. Note: half of all postmenopausal women will have an osteoporosis related fracture in their lifetime.
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16. Note: half of all postmenopausal women will have an osteoporosis related fracture in their lifetime.
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17. Risk factors for osteoporosis?
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a. Advancing age
b. Tobacco use c. Low body weight d. Caucasian or Asian ancestry e. Family history of osteoporosis f. Low calcium intake g. Sedentary lifestyle |
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18. In addition to the above factors, what are risk factors for osteoporosis in men?
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a. Prolonged use of corticosteroids
b. Presence of diseases that alter hormone levels such as chronic kidney or lung disease c. Undiagnosed low testosterone levels |
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19. How is screening for osteoporosis accomplished?
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a. The measurement of bone density by dual energy x-ray absorptiometry (DEXA)
b. Measurement of bone density is compared to the bone density of young adults and the result is reported as standard deviation from the mean bone density of the young adult (T-score). |
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20. When is osteoporosis present w/respect to the T-score?
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a. T-score at or below -2.5 (ie, measurement of the young adult mean).
b. Osteopenia is present if the T-score is between -1.0 and –2.5. |
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21. When is osteopenia present?
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a. -1.0 to -.2.5.
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22. Recommendations for calcium and Vit D for the prevention of osteoporosis?
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a. At least 1200 mg of calcium
b. 400-800 IU of Vit D per day for all women over age 50. |
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23. Side effects of Bisphosphonates?
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1. Esophagitis
2. Gastritis 3. Swallowing difficulty b. Should be taken on an empty stomach w/a full glass of water and the pt should stay upright for at least 30 min after taking the pill. |
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24. Indication for Alendronate (Fosamax)?
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a. Prevention and treatment of osteoporosis.
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25. Alendronate: Prevention and treatment dosages of osteoporosis dosage?
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a. Prevention: 5 mg or 35 mg weekly
b. Treatment: 10 mg daily or 70 mg weekly |
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26. Indication for Risedronate (Actonel)?
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a. Prevention and treatment of osteoporosis.
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27. Risedronate (Actonel): Prevention and treatment dosages of osteoporosis dosage?
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a. Prevention and treatment dosages:
b. 5 mg or 35 mg weekly or 150 mg monthly |
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28. Indication for Ibandronate (Boniva)?
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a. Prevention and treatment of osteoporosis.
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