osteoporosis Flashcards
When to repeat bone turnover markers after therapy is started?
Repeat after 3-6 months of your life treatment
What are the biochemical markers of bone resorption? (2)
- Serum C-telopeptide (CTX)
- Urinary n-telopeptide (ntx)
What are the biochemical markers of bone formation? (3)
1.serum amino-terminal propeptide of type 1 procollagen
2.bone-specific alkaline phosphatase (BALP)
3. Osteocalcin (OC)
What percentage of change in CTX indicates an success in anti-reabsorptive treatment?
40% reduction in CTX (double check that is correct)
Can someone ever get rid of the diagnosis of osteoporosis?
No-successful treatment can increase BMD, reduce fracture
risk, and improve T-score to the low bone mass or even the
normal range. However, in a person with a history of osteo-
porosis, a T-score in the osteopenic or normal range does not
change their diagnosis. The patient still has osteoporosis.
BMD may be improved, and fracture risk reduced; however,
microarchitectural deterioration remains, as do disease pro-
cesses responsible for that deterioration.
After how many years of bisphosphonate therapy should you consider a drug holiday?
after 3 years of IV bisphosphonates and after 5 years of oral bisphosphonates
when is the right time to check calcium on forteo?
obtain calcium right before next dose is due (forteo can cause calcium to be high)
generic drug name for forteo
Teriparatide
generic drug name for Tymlos
abaloparatide (no available on the market yet)
what is the box made with white lines on the DEXA called?
region of interest
What landmarks should you see on lumbar views of DEXA?
should see iliac crest (sometimes can see 12th rib)
On a DEXA can you look at L1 and L3-L4?
do not have to look at consecutive vertebra
region of interest of femur should not include:
greater trochanter, lesser trochanter, and ischium (trochanter has more cortical bone (more dense) so if included can falsely raise BMD)
If see a lot of the greater trochanter on femur view than what does that say about pt’s positioning?
malpositioned; rotated hip too much
what area of the femur should you use to compare on DEXA from one DEXA to the next?
total hip (not femoral neck)
at what GFR are bisphosphonates not used on-label?
GFR <35
how much of oral bisphosphonates get absorbed?
10%
