recall of old lady with normal Vit D and Ca. T score -2.5 JM–give alendronate
(1) long history about 55 yr postmenopausal female pt concerned about risk of osteoporosis , she had done an oesohageal opeartion and still complaining of some GiT problems, her t score cevical 2.5 and Lumbar T score -2.5, they give lab their ca level is normal and vit d level is normal and no mention in the Q about any menopausal symptoms,what is your most appropriate management ?
- ca plus vit d
and don’t think that there is option of zolidronic acid or these others #feb2017
She has osteoporosis as T score is -2.5 …A should be the answer but it causes oesophagitis
’HRT cannot be recommended in asymptomatic menopausal women to prevent osteoporosis’ JM1149
(2) Osteoporosis scenario with T score -2.5.All labs normal except low vitamin D. What to give?
e) Vitamin D3
We give vitamin D to patient with osteopenia or at risk to develop osteoporosis but she already had it so we need to treat it. I am with A
Option C and E means the same thing. Calcitriol or 1alpha(OH)D3 One-alpha-hydroxy-cholecalciferol is the active form of vitamin D (also called Vitamin D-3) and is given as first treatment in such a case - until normal level of vitamin D levels are attained. After that alendronate / calcium is added.
(3) Menopausal lady, T score -2.5, normal calcium, reduced 25(OH) , what to give
C- Cholecalciferol (vitD3)
Low serum levels of vitamin D should be corrected to a level above 50 nmol/L before commencing bisphosphonate therapy, as this increases the risk of hypocalcemia, especially with parenteral bisphosphonates such as zoledronic acid. ref RACGP
(4) Grandmother was watching her grandchildren playing, suddenly fell down had femur fracture, treated for fracture, then came back after 1 month, now how to manage her score is -2.5
- Tell not to put axial wt
5.Look 4 sec causes
already fracture occurs, alendronate should be started.