NUR 683- Exam #2 <STUDY GUIDE VERSION> || All Solved.
Risk factors of osteoporosis- lifestyle correct answers -Low body weight
-Low dietary calcium
-Vitamin D deficiency
-Excessive alcohol
-Cigarette smoking
-Advanced age
-Postmenopausal
Risk factors of osteoporosis- medications correct answers -Glucocorticoids
-Excessive thyroxine
-Long-term use of phenytoin
-Long-term use of PPIs
-Heparin
-Lithium
-Cyclosporine
Risk factors of osteoporosis- diseases correct answers -Thyrotoxicosis
-Hyperparathyroidism
-Hypogonadism
-Cushing's disease
-RA
-IBD
-Malabsorptive diseases
-Chronic renal insufficiency
,Osteoporosis- diagnostics correct answers **Bone Mineral Density (BMD) by dual x-ray
absorptionmetry (DXA) - evaluates central BMD at the spine/hip**
Questionnaire-based fracture risk assessment (FRAX) tool:
-uses risk factors to calculate 10-year risk of major osteoporotic fracture
-identifies candidates for pharmacotherapy
Osteoporosis- screening correct answers DEXA Q2-5 years in women not being treated for
osteoporosis:
-Women >65 years old
-Postmenopausal women age 50 and older with additional risk factors
DXA results correct answers Osteoporosis= T-score is -2.5 or less
^can also be diagnosed regardless of T-score in presence of fragility fracture
Osteopenia= T-score between -1.0 and -2.5
Routine labs for secondary causes of osteoporosis correct answers -CBC
-CMP
-TSH
-Albumin
-25-hydroxyvitamin D (form of vitamin D found in blood)
-24-hour urine for calcium excretion
Pharmacologic therapy is recommended for which groups of postmenopausal women? correct
answers -Those w/ an osteoporotic vertebral or hip fracture
, -Those w/ T-scores -2.5 or worse
-Those with T-scores from -1.0 to -2.5 and a 10-year risk (based on the FRAX calculator) of hip
fracture of at least 3% or other major osteoporotic fracture (spine, shoulder, wrist) of at least
20%
Adequate calcium & vitamin D intake for osteoporosis? correct answers Calcium- 1200 mg/day
^in women >50 yrs and in men >70 years old
Vitamin D- 800-1000 IU/day
^adults >50 yrs old
1st line pharmacological treatment for osteoporosis correct answers *Oral bisphosphonates*
^alendronate (FOSAMAX), risedronate
-IV biphosphonate (zoledronic acid) once yearly
-Denosumab/Prolia SQ every 6 months
Measure what before initiating bisphosphonates? correct answers *Serum calcium & creatinine*
^DO NOT use if hypocalcemia or renal impairment!
Pt counseling for oral bisphosphonates correct answers Ex. FOSAMAX
-Take first thing in the morning on an empty stomach (30-60 mins before food, drinks, & other
meds)
-May cause transient flu-like symptoms or osteonecrosis of jaw (usually w/ IV bisphosphonates)
Oral bisphosphonates- contraindications correct answers *Esophageal disorder*
Risk factors of osteoporosis- lifestyle correct answers -Low body weight
-Low dietary calcium
-Vitamin D deficiency
-Excessive alcohol
-Cigarette smoking
-Advanced age
-Postmenopausal
Risk factors of osteoporosis- medications correct answers -Glucocorticoids
-Excessive thyroxine
-Long-term use of phenytoin
-Long-term use of PPIs
-Heparin
-Lithium
-Cyclosporine
Risk factors of osteoporosis- diseases correct answers -Thyrotoxicosis
-Hyperparathyroidism
-Hypogonadism
-Cushing's disease
-RA
-IBD
-Malabsorptive diseases
-Chronic renal insufficiency
,Osteoporosis- diagnostics correct answers **Bone Mineral Density (BMD) by dual x-ray
absorptionmetry (DXA) - evaluates central BMD at the spine/hip**
Questionnaire-based fracture risk assessment (FRAX) tool:
-uses risk factors to calculate 10-year risk of major osteoporotic fracture
-identifies candidates for pharmacotherapy
Osteoporosis- screening correct answers DEXA Q2-5 years in women not being treated for
osteoporosis:
-Women >65 years old
-Postmenopausal women age 50 and older with additional risk factors
DXA results correct answers Osteoporosis= T-score is -2.5 or less
^can also be diagnosed regardless of T-score in presence of fragility fracture
Osteopenia= T-score between -1.0 and -2.5
Routine labs for secondary causes of osteoporosis correct answers -CBC
-CMP
-TSH
-Albumin
-25-hydroxyvitamin D (form of vitamin D found in blood)
-24-hour urine for calcium excretion
Pharmacologic therapy is recommended for which groups of postmenopausal women? correct
answers -Those w/ an osteoporotic vertebral or hip fracture
, -Those w/ T-scores -2.5 or worse
-Those with T-scores from -1.0 to -2.5 and a 10-year risk (based on the FRAX calculator) of hip
fracture of at least 3% or other major osteoporotic fracture (spine, shoulder, wrist) of at least
20%
Adequate calcium & vitamin D intake for osteoporosis? correct answers Calcium- 1200 mg/day
^in women >50 yrs and in men >70 years old
Vitamin D- 800-1000 IU/day
^adults >50 yrs old
1st line pharmacological treatment for osteoporosis correct answers *Oral bisphosphonates*
^alendronate (FOSAMAX), risedronate
-IV biphosphonate (zoledronic acid) once yearly
-Denosumab/Prolia SQ every 6 months
Measure what before initiating bisphosphonates? correct answers *Serum calcium & creatinine*
^DO NOT use if hypocalcemia or renal impairment!
Pt counseling for oral bisphosphonates correct answers Ex. FOSAMAX
-Take first thing in the morning on an empty stomach (30-60 mins before food, drinks, & other
meds)
-May cause transient flu-like symptoms or osteonecrosis of jaw (usually w/ IV bisphosphonates)
Oral bisphosphonates- contraindications correct answers *Esophageal disorder*
