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Medicine > Parathyroid Disease > Flashcards

Parathyroid Disease Flashcards

1
Q

what is the function of PTH in the bone?

A

inc. osteoclast activity

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2
Q

what is the function of PTH in the kidney?

A

holds onto Ca
wastes phosphorus and bicarb
stimulated synthesis of vitamin D (increasing absorption of Ca in the gut)

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3
Q

what is the pathway of vitamin D/

A
  1. dietary D2, D3 or D3 from sunlight
  2. liver turns D3 into 25 OH vitamin D
  3. kidney covnerts 25 OH to 1, 25 OH vitamin D (active form)
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4
Q

which vitamin D level do we test for?

A

25 hydroxyvitamin D

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5
Q

what is the daily recommended dose of Ca (including dietary)?

A

1000-1200mg

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6
Q

what is the daily recommended dose of vitamin d?

A

2000IU

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7
Q

what are common side effects of bisphosphonates?

A 
GI upset
esophagitis/cancer
gastric ulcer
atypical chalk-stick femoral fractures
BRONJ (necrosis of the jaw)
hypercalcemia
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8
Q

how do bisphosphonates need to be taken?

A

first thing in the morning with a full glass of water and don’t eat for an hour

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9
Q

what are contraindications of bisphosphonates?

A

esophageal dz
inability to sit to stand upright
hypocalcemia

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10
Q

what are bisphosphonate agents?

A

risedronate (actonel) qweek or qmonth
alendronate (fosamax) qday or qweek
ibandronate (boniva) qmonth or q3months (not as much fx reduction data)

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11
Q

what is zolendronic acid (reclast) used for?

A

osteoporosis
q12 months
$$$$

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12
Q

what are contraindications of reclast?

A

CrCl ,35

BRONJ

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13
Q

over what time frame would forteo be given?

A

2 yr course

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14
Q

what are contraindications of forteo?

A

paget’s dz
bone mets
hypercalcemia

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15
Q

what type of pt should receive forteo?

A

young pt

hypogonadal osteoporosis in male

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16
Q

what type of fractures do SERMS reduce more than others?

A

vert (40%) over non vert

17
Q

which osteoporosis drug reduces risk of breast cancer?

A

evista (raloxifene)

18
Q

what risk does evista increase?

A

DVT and hot flashes

19
Q

what are the major side effects of prolia?

A

BRONJ
hypocalcemia
serious infections
dermatologic rxns

20
Q

when is ERT/HRT therapy recommended?

A

prevention of postmenopausal osteoporosis (use conservatively and get a good breast ca hx)

21
Q

how does estrogen impact bone?

A

inhibits osteoclasts

22
Q

when would you give a pt calcitriol?

A

vitamin D deficiency with kidney or renal dz

23
Q

what is the most common cause of hypoparathyroidism?

A

post thyroid or parathyroid surgery

24
Q

what does Mg do to PTH levels?

A

lowers them by preventing PTH secretion

25
Q

what is pseudohypoparathyroidism?

A

disorders caused by renal resistance to PTh

Medicine (146 decks)

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