Pales Bone CIS

Question 1

why not give bisphosphanates to lady with hypercalcemia due to hyperparathyroidism?

Answer 1

need to take out the parathyroid problem to really treat the hypercalcemia

Question 2

53 year-old woman presents with complaints of weakness, malaise, constipation, and back pain. While being evaluated, she becomes somewhat lethargic.

Her calcium is super high. What do we do?

Answer 2

give fluids
maybe forced diuresis (furosemides)

and IV bisphosphanates

Question 3

hypercalcemia with low PTH. Next step?

Answer 3

Vitamin D levels
 PTH-RP
Bone scan (for cancer)
TSH and Free T4, T3 for hyperthyroidism
multiple myeloma w/u (SPEP/ UPEP)
ACE level for sarcoidosis

Question 4

low calcium. next step?

Answer 4

do the albumin calcuation

still low, so check PTH, phosphate, and creatinine

Question 5

what to check for vitamin d deficiency

Answer 5

25 Hydroxy-Vitamin D level

Question 6

Z score of -2 or less should prompt you to

Answer 6

look for other causes of osteoporosis besides just being post-menopausal

Question 7

what do we give for primary post-menopausal osteoporosis

Answer 7

bisphosphanates

watch out for esophagitis and don’t lie down right after taking
don’t take with food (low absorption rate)

Question 8

best choice to treat osteoporosis in women with history of breast cancer?

Answer 8

estrogen receptors