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;
67 Cards in this Set
- Front
- Back
|
What genetic risk factors are associated with osteoporosis |
Caucasian or asian Family hx OP or fractures Small body frame |
|
|
What lifestyle risk factors are associated with OP |
Sedentary Smoking Alcohol Decreased sun exposure |
|
|
What are dietary risk factors for OP |
Dec Ca intake Increase caffeine Inc phosphates Weight loss of >10% after age 50 |
|
|
What are gynecological risk factors for OP |
Late menarche Nulliparity Amenorrhea assoc w/ exercise drugs or anorexia |
|
|
What chronic illnesses inc the risk of op |
Hthyroidism DM (esp drug induced) Cushings syndrome RA |
|
|
What medications inc the risk of OP |
Excess thyroid replacement Glucocorticoids Heparin Lithium Chemo GnRH agonists (non pulsatile) Anticonvulsants |
|
|
What are some non pharm ways to prevent or treat OP |
Smoking cessation weight bearingExercise Limit caffeine and OH Inc Ca and Vit D Fall prevention |
|
|
A DEXA reading is a T Score, and must be converted to ____ in order to be meaningful |
Z score |
|
|
A z score is ____ |
The number of SD from the mean of the reference population |
|
|
A t score of ____ can be significant for OP |
-2.5 or less |
|
|
If ___ is accompanied by one or more risk factors, pharmacological treatment is often used for prevention |
Osteopenia |
|
|
____ is based on 12 questions and is a computer calculation that gives the 10 year probability of qb osteoporotic related fracture |
FRAX calculation |
|
|
In order to answer yes to the GC question, you must have taken _______ or more of a drug like predinisone 5 mg/day |
3 months |
|
|
Yes for RA on the frax calculation means ____ |
A confirmed diagnosis of RA |
|
|
Yes to secondary op means |
They have a condition that is strongly linked to OP |
|
|
What are limitations of the FRAX calculation |
It doesn't account for prior smoking history , stroke history, vision problems, or neurologic problems It doesnt account for previous BP use |
|
|
What is the proper dose for calcium in a patient under 65 |
500-600 mg BID |
|
|
What is the proper dose for calcium in a patient over 65 |
500-600 mg TID |
|
|
What are issues with calcium |
It may inhibit absorption of other drugs Rebound hyperacidity Constipation and inc kidney stone risk |
|
|
Thiazide diuretics ____ sCa by ____ urinary excretion of Ca |
Increase Decreasing |
|
|
Loop diuretics ____ sCa |
Decrease |
|
|
What dose of regular Vit D should be given each day to treat OP |
800-1000 IU |
|
|
What dose of activated Vit D should be given each day to treat OP |
0.25 mcg po BID |
|
|
Activated vit d may be needed in patients with ____ |
Advanced OP, liver dx, or renal dx |
|
|
What types of hormone therapy is used in op patients |
Combo products Estrogen SERMS BPs Calcitonin nasal spray Teriparatide Phytoestrogens Fluoride Growth Hormone factors |
|
|
What combo products are used in op |
Prempro: premarin and provera qd Premphase: premarin daily and provera last ten days |
|
|
What SERMs are used in OP treatment |
Evista Droloxifene Bazedoxifene (duavee) |
|
|
What is a benefit of serms over ert |
They avoid unwanted CV se |
|
|
Alendronate is used to ___ |
Treat and prevent OP treat GC OP Treat Paget's disease |
|
|
Residronate is used ___ |
To treat OP Treat GC induced OP Treat Paget's disease |
|
|
Ibandronate is used to __ |
Treat and prevent OP |
|
|
If an oral once weekly bp dose is missed, it should be taken _____ |
in the AM after it is remembered, and the patient should return to taking it once per week on their normal day |
|
|
If a once monthy BP dose is missed and it is >7 days away from next dose, |
Take in the am after it is remembered and return to once a month |
|
|
Zolendroic acid is given qyear for _____ |
Prevention and treatment of OP |
|
|
A patient must have a CrCl of at least ____ in order to take reclast |
35 |
|
|
_______ should be given following a reclast injection |
Ibuprofen or acetaminophen |
|
|
a patient taking reclast MUST ______ |
Supplement with ca and vit d daily throughout the year |
|
|
Etidronate is given po or iv to treat |
Pagets disease Heterotropic ossification |
|
|
Pamidronate is given IV to treat |
Paget's disease Hypercalcemia of malignancy |
|
|
Tiludronate is given orally to treat |
Pagets disease |
|
|
Calcitonin nasal spray is given to women who cant takeCa or BPs for OP associated with _____ |
Past bone fractures Bone pain |
|
|
Teriparatide is an analog to ___ |
PTH |
|
|
Forteo is used in |
men and women at high risk of fracture |
|
|
_____ is the FIRST approvrd OP agent that stimulates new bone formation |
Forteo |
|
|
Growth hormone factors may have a role in combination therapy if given in____ |
A pulsatile manner |
|
|
Patients on long term GC therapy should take ____ |
Ca, vit D A Thiazide diuretic BP if elderly Calcitonin therapy in elderly pt with past bone fractures or bone pain |
|
|
BMD should be done every _____ months in pts on GC |
6-12 |
|
|
Monthly GC monitoring parameters include: |
CBC CHEM 7 Vital Signs (esp WGT and BP) |
|
|
GC monitoring parameters that should be done every 6 months include _____ |
Eye exams Hemoccult Chest xrays and PPD DEXA scan |
|
|
All women on GC should take ___ |
An estrogen or SERM |
|
|
Children develop a condition known as ____ due to long term deficien in vit D |
Rickets |
|
|
Premenopausal women usually develop OP from ____ |
secondary causes |
|
|
Transplant op is possibly due to : |
Other underlying conditions High dose corticosteroid use Calcineurin inhibitor use |
|
|
CKD can cause ____ due to the kidney's inability to activate vit D |
Renal osteodystrophy |
|
|
Renal osteodystrophy results i |
Low Ca absorption Low bone absorption Inc PTH release leading to Inc bone resorption |
|
|
Results of a recent study showed that _____ may be better than alendronate for GC induced OP |
Teriparatide |
|
|
Denosumab side effects include: |
Inc infection risk , joint pain, and inc rate of skin abnormalities like eczema and rash |
|
|
Denosumab usual dose ____ |
60mg subQ q6mth |
|
|
Teriparatide is a _____ |
Recombinant PTH |
|
|
PTH stimulates vit d activation, inc Ca absorption, and when given in a pulsatile manner____ |
Ensures OB activity > OC activity |
|
|
Usual teriparatide dose is ____ |
20mcg subQ qd |
|
|
Etiologies of OP in men include: |
Age related HoGonadism GNRH agonist/ antag induced (prostate cancer drug tx) |
|
|
How can age related HoGonadism resulting in OP be treated in men |
TRT |
|
|
How can OP caused by prostate cancer tx be treated |
Bp, Teriparatide shown to work better recently |
|
|
Drug induced OP caused by breast cancer treatment (anastrozole or letrozole) can be treated with ___ |
Zoledronic acid 4 mg |
|
|
OP caused by over replacement of thyroid hormone can be treated by____ |
Adjusting thyroid replacement to upper part of normal range in women with pre existing OP |
|
|
People taking anticonvulsants such as pheno phenyl or carba who develop OP should be ____ |
Given added VIT D or alternate anti seizure therapy should be considered |
