Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
29 Cards in this Set
- Front
- Back
|
bone strength =
|
bone density + bone quality
|
|
|
bone density =
|
grams of mineral / area
|
|
|
what is osteopenia?
|
-lower than normal BMD, but not low enough to be diagnosed as osteoporosis
|
|
|
what is the preferred and standard diagnostic test for determining BMD?
|
-DEXA (dual energy X-ray absorptiometry)
-very little radiation is emitted |
|
|
where does DEXA measure bone density?
|
-hip or spine
|
|
|
DEXA findings?
1. Normal bone density 2. osteopenia 3. osteoporosis 4. severe osteoporosis |
1. within 1 SD of young adult mean
2. 1-2.5 SD below YAM 3. >2.5 SD below YAM 4. >2.5 SD below YAM and one or more broken bones/fractures |
|
|
_________is a new laboratory study that increases in patients with osteoporosis and Paget's disease
|
N-telopeptide
|
|
|
what is the first line treatment of osteoporosis and when should it start?
|
-prevention
-adolescent women should have adequate nutrition, calcium, vit D, and excercise |
|
|
How much calcium do the following patients need per day?
1. children 1-10 2. men, premenopausal women, and post menopausal women also taking estrogen 3. teenagers and young adults 11-24 yrs of age 4. post menopausal women not taking estrogen 5. pregnant and nursing mothers |
1. 800mg
2. 1000mg 3. 1200mg 4. 1500mg 5. 1200-1500mg |
|
|
max dose of calcium?
|
2000mg per day
|
|
|
__________is the perferred form of calcium for most pts, but if indigestion or constipation can try ____________
|
1. calcium carbonate
2. calcium citrate |
|
|
why should calcium be divided into 2-3doses per day?
|
because intestines can only absorb about 500 mg at a time
|
|
|
how much vit D do men and women over age 71 need per day?
|
-800mg
|
|
|
which agents decrease the removal of calcium from bones and how should they be taken?
|
-biphosphonates
-in the morning 30 min before food, with water |
|
|
SERMS such as __________are very effective at preventing spinal fractures
|
raloxifene
|
|
|
SERMS:
1. MOA 2. ADR |
1. act like estrogen on the bone
2. DVT, PE |
|
|
which drug is a hormone approved by the FDA for treating osteoporosis?
|
calcitonin
|
|
|
Teriparatide is a ________which helps regulate calcium metabolism
|
-synthetic version of the human parathyroid hormone
|
|
|
Denosumab is an____________that blocks a chemical messenger that plays a role in promoting bone thinning
|
-intravenous infusible antibody
|
|
|
treatment for men with osteoporosis typically involves?
|
-testosterone replacement and biphosphonates
|
|
|
Paget's disease
|
-characterized by disoredered bone remodeling
-bones are malformed, enlarged, less dense, and more prone to fracture -men affected more than women -cause unknown(genetics and viral triggers) |
|
|
how does Paget's disease usually present?
|
-usually asymptomatic
-usually discovered incidentally |
|
|
Which bones are most affected in Paget's disease?
|
-spine, femur, pelvis, skull, clavicle, and humerus
|
|
|
when and why does Paget's disease start to hurt?
|
-enlarged bones can encroach upon adjacent nerves
-bowing of legs involving knees and hips can lead to arthritis, limping, pain, and stiffness |
|
|
what symptoms can be present when Paget's disease affects the skull bones?
|
- headache, loss of vision, and hearing
|
|
|
Very widespread Paget's disease can lead to _______
|
CHF
|
|
|
DX of Paget's dz
1. imaging 2. blood test |
1. bone scan
2. serum alkaline phosphatase |
|
|
mainstay of tx for Paget's disease?
|
-biphosphonates
-three biphosphonates approved for Paget's but not osteoporosis:: etidronate, pamidronate, tiludronate |
|
|
tx for Paget's dz other than biphosphonates?
|
-watchful waiting if asymptomatic
-NSAIDs, orthotic devices, surgery -calcitonin -plicamycin ?(anti-neoplastic drug for hypercalcemia) |
