Endocrine

Question 1

risk factors of osteoperosis

Answer 1

Smoking
Alcohol
Rheumatoid Arthritis 
Disease states (IBD, other malabsorption syndromes, chronic hepatic disease)
Advanced age
Low body weight
History of fractures (including family history of hip fracture)
History of steroid treatment 
Vitamin D and calcium deficiency

Question 2

role of estrogen in preventing osteoporosis

Answer 2

decrease osteoclast activity, increase osteoblast activity

Question 3

What are the side effects of estrogen and under what conditions is it beneficial?

Answer 3

● Cardiac problems if taken 10+ years after menopause, breast CA, DVT, gallbladder, stroke
● Women within 10 years of menopause can take estrogen to decrease risk of osteoporosis w/o increased risk of cardiac problems
● Indicated for postmenopausal osteoporosis, hot flashes, colon cancer, vasomotor issues during menopause

Question 4

What are the side effects of bisphosphonates and what should you look for in patients who have taken them for a long period of time?

Answer 4

ADR’s: ulcers, esophagitis, osteonecrosis of the jaw when administered intravenously in cancer patients,
Patients taking drug for ~10 years: rare atypical fractures with minimal impact preceded by dull aching pain in the the thigh and groin