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Geriatrics > Ger 9 Osteoporosis > Flashcards

Ger 9 Osteoporosis Flashcards

1
Q

Prolonged use of what drugs can lead to an ↑ risk for fractures in people both older and younger than 50?

A

Glucocorticoids

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2
Q

What 3 chronic conditions in younger adults predisposes them to fractures?

A

Hypogonadism or premature menopause
Malabsorption syndrome
Primary hyperPTH

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3
Q

What 2 fractures in older adults are clinical risk factors for more fractures?

A

parental hip fractures

vertebral fx

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4
Q

What 2 bad habits in older adults are clinical risk factors for more fractures?

A

Current Smoking

high alcohol intake

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5
Q

What weight issues predispose older adults as clinical risk factors for more fractures?

A

Low body weight (< 60 kg)

Major weight loss (> 10% of bw at age 25)

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6
Q

What chronic disease in older adults are clinical risk factors for more fractures?

A

Rheumatoid arthritis

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7
Q

What method can u measure bone mineral density?

A

Dual-energy x-ray absorptiometry

sounds futuristic.

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8
Q

How do bisphosphonates, RANK ligand inhibitors, selctive estrogen receptor modulator, hormone therapy, and calcitonin help treat osteoporosis?

A

They’re anti-resorptive agents

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9
Q

What is the 1 bone forming drug for the Tx of osteoporosis?

A

Teriparatide

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10
Q

What % of the risk for vertebral fractures is reduced when using pharmacotherapy?

A

30-70%

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11
Q

Calcitonin and teriparatide may decrease what Sx that’s associated with vertebral fractures?

A

Pain

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12
Q

True or False: in addition to bisphosphonates, there is evidence that testosterone reduces vertebral fractures.

A

False

There’s no evidence that testosterone reduces fxs

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13
Q

What are the 4 first line drugs for the prevention of hip, non-vertebral, and vertebral fxs?

A

Alendornate
Risedronate
Zoledronic acid
Denosumab

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14
Q

What is the first line therapy for preventing vertebral fxs?

A

Raloxifene

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15
Q

What you should consider in menopausal women for the prevention of fxs?

A

Hormone therapy

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16
Q

If woment are intolerant of 1st-line therapies, what 2 drugs cna u give for the prevention of vertebral fxs?

A

Calcitonin or etidronate

17
Q

What are the 3 drugs for the first line therpy for the prevention of fxs in MEN?

A

Alendronate, Risedronate, and zoledronic acid

same for women except no denosumab

18
Q

What are the 2 adverse effects of high-dose Ca supplements?

A

Increased risk of renal calculi and CV events

19
Q

What Sx are a side effect to bisphosphonates?

A

self-limited flu-like Sx

20
Q

What skin disease is an adverse effect of denosumab?

A

Increased risk of cellulitis

21
Q

What “events” are at an increased risk for using raloxifene and hormone therapy?

A

thromboembolitic events (including PE)

22
Q

What 2 Ca problems might happen with the use of teriparatide?

A

hypercalciuria and hypercalcemia

23
Q

What is the risk if the 10-year fx risk is > 20% or there is a prior fragility fx of hip/spine or there is > 1 fragility fx?

A

High risk

24
Q

What should you offer high risk pts?

A

Pharmacologic therapy

25
Q

If a high risk pt is already undergoing pharmacological therapy, what must be performed within 1-3 years?

A

bone mineral density

26
Q

What might be the cause of continued loss of bone mineral density or a new fx in high risk pts?

A

poor adherance to therapy, failure to respond to therapy, or previously unrecognized 2o causes of osteoporosis

27
Q

What is the 10-year fx risk in moderate risk pts?

A

10-20%

28
Q

When should you repeat bone mineral densities in moderate risk pts?

A

after 1-3 yrs

29
Q

If there is a 10-year fx risk < 10%, what risk is the pt for fractures?

A

low risk

30
Q

True or False: despite being a low risk, pharmacological therapy is encouraged to prevent the progression of osteoporosis.

A

FALSE

typically lifestyle changes is adequate

31
Q

When should you test for bone mineral density in low risk pts?

A

5-10yrs

Geriatrics (15 decks)

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