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Flashcards in Parathyroid Disease Deck (25):
1

what is the function of PTH in the bone?

inc. osteoclast activity

2

what is the function of PTH in the kidney?

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

3

what is the pathway of vitamin D/

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)

4

which vitamin D level do we test for?

25 hydroxyvitamin D

5

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

1000-1200mg

6

what is the daily recommended dose of vitamin d?

2000IU

7

what are common side effects of bisphosphonates?

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

8

how do bisphosphonates need to be taken?

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

9

what are contraindications of bisphosphonates?

esophageal dz
inability to sit to stand upright
hypocalcemia

10

what are bisphosphonate agents?

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

11

what is zolendronic acid (reclast) used for?

osteoporosis
q12 months
$$$$

12

what are contraindications of reclast?

CrCl ,35
BRONJ

13

over what time frame would forteo be given?

2 yr course

14

what are contraindications of forteo?

paget's dz
bone mets
hypercalcemia

15

what type of pt should receive forteo?

young pt
hypogonadal osteoporosis in male

16

what type of fractures do SERMS reduce more than others?

vert (40%) over non vert

17

which osteoporosis drug reduces risk of breast cancer?

evista (raloxifene)

18

what risk does evista increase?

DVT and hot flashes

19

what are the major side effects of prolia?

BRONJ
hypocalcemia
serious infections
dermatologic rxns

20

when is ERT/HRT therapy recommended?

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

21

how does estrogen impact bone?

inhibits osteoclasts

22

when would you give a pt calcitriol?

vitamin D deficiency with kidney or renal dz

23

what is the most common cause of hypoparathyroidism?

post thyroid or parathyroid surgery

24

what does Mg do to PTH levels?

lowers them by preventing PTH secretion

25

what is pseudohypoparathyroidism?

disorders caused by renal resistance to PTh

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