| A. Bisphosphonates |
dr confused, telomerase, filatino, darkhorse, Korotkoff, KARIME |
6 |
24% |
| B. Calcitonin |
|
0 |
0% |
| C. Calcium and vitamin D |
MAGY17, Kamsi, nitin_ps, Justice, princy, pradeepbalu, wywywy2006, drfax, adcooley121 |
9 |
36% |
| D. Conjugated estrogens |
dr in trouble, liliaeliz, doyoudig, neuroblastoma, numita, ifiMD, tamerbashir, DanVitor, new_new2000 |
9 |
36% |
| E. Sodium fluoride |
|
0 |
0% |
| Author | 19 Posts |
skinyballs
Forum Junior
Topics: 14
Posts: 26
|
A 52-year-old woman is seen by in clinic for advice on osteoporosis. She has been a patient there for a number of years. She has a past medical history significant for hypertension and diet-controlled diabetes mellitus. She smokes 1 pack of cigarettes per day. She was documented by previous LH and FSH levels to be in menopause within the last year. She is concerned about "breaking her hip when I'm old" and she is seeking advice on osteoporosis prevention. She should be told that independent of side effects, the best therapy currently available for prevention is which of the following?
A. Bisphosphonates
B. Calcitonin
C. Calcium and vitamin D
D. Conjugated estrogens
E. Sodium fluoride
Edited by new_n_lost on 08/21/07 - 07:36 PM. Reason: Deleted the Ad in the Question
|
| MAGY17
Forum Elite
Topics: 30
Posts: 234
|
THE ANS IS C
THE BEST TX FOR OSTEOPOROSIS......>BISPHOPHONATES AND SERMS
THE BEST TO PREVEN OSTEOPOROSIS......>CALCIUM AND VIT-D INTAKE, WEIGHT BEARING EXERCISE, NO CIGARETTES NO ALCOHOL
|
| dr in trouble
Forum Guru
Topics: 60
Posts: 592
|
The best way to prevent osteoporosis in postmenopausal women is HRT.
___________________
If u want to do something, do it today as there is no tomorrow.
|
| liliaeliz
Forum Elite
Topics: 38
Posts: 349
|
C, si magaly,
|
| doyoudig
Forum Guru
Topics: 144
Posts: 613
|
agree w/ dr in trouble
|
| doyoudig
Forum Guru
Topics: 144
Posts: 613
|
she is postMenaupause so DDDDD
|
| Justice
Forum Fanatic
Topics: 101
Posts: 1,964
|
C. Calcium and vitamin D
As for dr in trouble wrote:
The best way to prevent osteoporosis in postmenopausal women is HRT. - it is a temporary measure, but it does work...
Also all of us read here: http://www.nof.org/prevention/
___________________
Don't live in a town where there are no doctors
|
| neuroblastoma
Forum Guru
Topics: 99
Posts: 1,016
|
justice..did u notice ''''this paragraph in ur link
Medications for Prevention and Treatment
Although there is no cure for osteoporosis, currently bisphosphonates (alendronate, ibandronate and risedronate), calcitonin, estrogens, parathyroid hormone and raloxifene are approved by the US Food and Drug Administration (FDA) for the prevention and/or treatment of osteoporosis.
whynot D answer ESTROGEN???
|
| Justice
Forum Fanatic
Topics: 101
Posts: 1,964
|
neuroblastoma,
thanks for reading the link that carefully...
I have nothing against estrogen, but you cannot use it indefinitely (please also note that it is not an over-the-counter medication) whereas calcium+VitD can be bought in every Walgreens... In addition, the last option has an impact onto pathogenesis of the osteopenia/porosis
In any case, this is just my opinion
___________________
Don't live in a town where there are no doctors
|
| tamerbashir
Forum Elite
Topics: 20
Posts: 284
|
HRT
|
| cool doctor
Forum Junior
Topics: 1
Posts: 226
|
The Q SAYS:
She should be told that independent of side effects, the best therapy currently available for prevention is which of the following?
so independent of SE the best is HRT.
but in general it will be bisphosphonate or raloxifene I guess!
|
| me007
Forum Guru
Topics: 72
Posts: 803
|
RISK FACTORS FOR FRACTURE — People who have risk factors for fracture, especially postmenopausal women and men over 60 should talk to their healthcare provider about being screened for osteoporosis, especially if one or more of the following risk factors are also present.
1. Age — In people aged 90 years or more, approximately one-third of women and 15 percent of men will have a hip fracture.
2. Cigarette smoking
3. Long-term use of steroid (glucocorticoid) medications such as prednisone
4. Low body weight (less than 127 lbs or 58 kg)
5. Rheumatoid arthritis
6. History of a non-traumatic bone fracture in self or parents (eg, breaking a bone after falling from standing height or less)
7. Excessive alcohol consumption
When to measure BMD
Bone density testing can be used to diagnose osteoporosis, as well as to screen for it. The National Osteoporosis Foundation has issued recommendations for bone density testing that primarily apply to white women after menopause. Bone density should be measured in women:
1. Greater than 65 years of age
2. Under age 65 who have one or more risk factors for osteoporotic fracture in addition to menopause.
3. The International Society for Clinical Densitometry (ISCD) recommends bone density testing for men over 70 years of age and for adults (including premenopausal women):
- With a non-traumatic fracture (after a fall from standing height or less)
- With disease associated with low bone mass (Cushing's syndrome, hyperthyroidism, hyperparathyroidism, rheumatoid arthritis, gastrointestinal diseases such as inflammatory bowel disease or celiac disease)
- Taking drugs associated with low bone mass (glucocorticoids, GnRH agonists, some chemotherapy drugs)
http://patients.uptodate.com/topic.asp?file=minme...
|
| me007
Forum Guru
Topics: 72
Posts: 803
|
1 pack a day - she has one more risk factor in addition to her menopause, so she should be screened for osteoporosis, educated abt diet-exercise-smoking.
Conjugated estrogens - not good choice, contain only estrogens, (it is not raloxifen) puts her at risk for cancer.
i woud say bisphosphonate, bcs there is not raloxifen as a choice but after Bone density scan, (remembering all side effects)
|
| me007
Forum Guru
Topics: 72
Posts: 803
|
the q actually asks abt "independent of side effects, the best therapy currently available for prevention"
and this is bisphosphonates
If the prevention and treatment of osteoporosis is the only issue under consideration, then bisphosphonates such as alendronate, ibandronate, or risedronate are more effective than menopausal hormone therapy in preventing osteoporotic fractures, and less likely to be associated with substantial adverse effects. So far, bisphosphonates are the most effective category or prescription medications for treating postmenopausal osteoporosis.
|
| wywywy2006
Forum Elite
Topics: 43
Posts: 166
|
agree with 007. HRT is only indicated when the patient also has menopausal syndrome. Otherwise, biphosphate is the best one.
|
| wywywy2006
Forum Elite
Topics: 43
Posts: 166
|
Calcium and Vitamin D don't work in menopausal women
|
| hero
Forum Elite
Topics: 37
Posts: 460
|
q is from q bank, ans is bit conflicting, but here it is
The correct answer is
D. Early intervention can prevent osteoporosis. Later intervention can halt its progression, but it is not currently possible to reverse established disease. All current therapies for osteoporosis are directed at inhibiting bone resorption. Bone loss is greatest within the first year of menopause so these agents are likely to be most efficacious if started at this time. Estrogen reduces the rate of bone loss and improves density. The beneficial effects of estrogen replacement are well-documented, and it is estimated that less than 20% of women are taking estrogens, despite their enormous benefit. Additionally, estrogen replacement has been shown to be important for prevention of coronary disease in this age group.
Bisphosphonates (choice A) are agents that inhibit osteoclastic bone resorption. These agents are efficacious for both prevention and treatment of disease. In some trials, their effect on augmenting bone density is similar to that of estrogens. However, given the side effects of these agents (esophagitis) as well as the other beneficial effects of estrogens (effects on HDL, LDL and coronary disease), estrogen is still the agent of choice for prevention.
Calcium and vitamin D (choice C) are critical components of prevention and ongoing treatment, but the effects of giving calcium and vitamin D supplements are proportional to the duration of therapy. Most postmenopausal women receive less than the recommended calcium intake (1500 mg/day) and have hypovitaminosis D (<15 ng/mL 25-hydroxy vitamin D levels). Calcium and vitamin D is the cornerstone of good therapy whether hormone replacement is utilized or not, but the effects are generally not significant unless begun early in life.
|
| cool doctor
Forum Junior
Topics: 1
Posts: 226
|
could u put the question hero?
|
| hero
Forum Elite
Topics: 37
Posts: 460
|
cool doctor wrote:
could u put the question hero?
it is word to word same question
|
|
| |
| | | | | | | | | | | | | | | | | | | |
You don't have permission to post.
|
