osteoporosis Flashcards
dx criteria for osteoporosis
t score of less than -2.5 at hip
dx criteria for osteopenia
t score of -1.5 to -2.0
what is the supplementation for osteoporosis
calcium 1200 mg w/800 IU vit D
smoking cessation
what exercises are best for osteoporosis
weight bearing walking, yoga, dancing, strength training
therapy keys
before drug therapy, have normal calcium and vit D levels
first line drugs for osteoporosis
biphosphanates ( fosomax, actonel )
take in am w/ full glass of water , stay upright, do not lay flat for 30-60 min
monitoring - 2 years after start of therapy
contraindiaction for biphosphanantes
esophageal motility disorder, PUD, CKD, esophageal strictures,
SERMS
Raloxifine Tamoxifine
can increase risk of DVT, PE, death from stroke cancer of uterus
common s/e : menopause
PCOS
occurs after puberty
infrequent ovulation, infrequent menses, infertility, insulin resistance.
will have hirsutism, obesity, amenorrhea
pelvic US: enlarged ovaries with “ring of pearl”
tx: low dose OCP. if want to get pregnant may give metformin to cause ovulation, weight loss
PCOS risks
obesity, HTN, DM2, metabolic syndrome, HLD, breast cancer , endometrial cancer, CAD
Fibrocytic Breast dx
bloated/enlarged lumpy cystic and tender breast a few days before menstual cycle , once menses starts, symptoms resolve
PE: multiple tender cyctic lumps present in breasts
if they have this on your exam have them
return a few days after onset on menstraul peroid for another breast exam
when to refer for breast findings
dominant mass, “hard” mass, attached to skin, dimpling , “peu deorgange” breast d/c, scaly rash on the nipple and areole ( pagets dx)
order mammograms and refer
Ruptured Ectopic Preg
6-12 weeks of gestation
acute onset pelvic/ abdominal pain w/ ammenorhea for 6-8 weeks
