MSK

Question 1

Morning stiffness in the hands or joints lasting >30 minutes should make you think of?

Answer 1

Osteoarthritis

Question 2

What medications can we offer the elderly for pain?

Answer 2

APAP is 1st choice (fewer SE’s though less effective than NSAIDs)

Can consider Tramadol or Cymbalta if APAP fails

Question 3

If a pt’s T score is 2 SD below normal – what do they have?

Answer 3

Osteopenia

Question 4

What T score indicates osteoporosis?

Answer 4

2.5 SD below normal

Question 5

Where are the most common sites for osteoporosis to occur?

Answer 5

Hip, spine, and wrist

Question 6

What are the key nutrients associated with osteoporosis?

Answer 6

Cal, Phosphorus, Mg, K, D, A

Question 7

When do we start screening women for osteoporosis?

Answer 7

65+

Men after age 70!

Question 8

What are some examples of toxins/meds that can cause osteoporosis?

Answer 8

Alcohol, anticonvulsants, antipsychotics, steroids, heparin, lithium, nicotine, SSRI

Question 9

How much vit D should women be getting?

Answer 9

D3 at least 800IU

Question 10

How much calcium should women be getting?

Answer 10

1200mg/d for women 50+

Question 11

How do we treat osteoporosis pharmacologically?

Answer 11

Bisphosphonates! (alendronate)

• MUST be taken on an empty stomach with water & must remain upright x30 minutes after
• Don’t use in renal failure

Question 12

Name 6 types of hip fractures?

Answer 12

• Subcapital neck
• Trancervical neck
• Intertrochanteric
• Subtrochanteric
• Greater trochanter
• Lesser trochanter