Osteoporosis Treatment Alternatives and Prevention Strategies

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Questions and Answers

What are the three estrogens commonly found in oral contraceptive pills?

  • Estradiol, Estriol, Estrone
  • Estradiol, Ethinyl estradiol, Estropipate (correct)
  • Ethinyl estradiol, Mestranol, Estropipate
  • Estriol, Ethinyl estradiol, Estropipate

What are the unique properties of Beyaz and Safyral among combination oral contraceptives?

  • Higher progestin content
  • Include a folic acid supplement (correct)
  • Contain a diuretic component
  • Lower estrogen content

How is Nuvaring typically used as a contraceptive method?

  • Oral administration
  • Intravenous injection
  • Subcutaneous implantation
  • Vaginal insertion (correct)

What is the primary drawback of progestin-only contraceptives?

<p>Must be taken at the exact same time daily (B)</p> Signup and view all the answers

What are the indications of prostaglandins in a medical context?

<p>Induction of labor (D)</p> Signup and view all the answers

What are the rare side effects associated with phosphodiesterase type 5 (PDE-5) inhibitors?

<p>Hearing loss and vision changes (C)</p> Signup and view all the answers

What is a potential risk associated with using Canagliflozin for diabetes?

<p>Urinary Tract Infections (UTIs) (D)</p> Signup and view all the answers

Which medication is contraindicated in gestational diabetes?

<p>Glucotrol (C)</p> Signup and view all the answers

What is the appropriate Levothyroxine dosage for Stacy, a 30-year-old with elevated TSH and low Free T4 weighing 100 lbs?

<p>75 mcg (D)</p> Signup and view all the answers

Which medication is typically used to treat symptomatic hyperthyroidism in the first trimester of pregnancy?

<p>Propylthiouracil (D)</p> Signup and view all the answers

What potential issue should Jane, a type 1 diabetic taking a beta blocker, be aware of?

<p>Impaired glycogenolysis response to low blood glucose (D)</p> Signup and view all the answers

What interval is considered optimal for reassessing TSH after adjusting Levothyroxine dosage?

<p>6-8 weeks (B)</p> Signup and view all the answers

What is the main purpose of combining levomefolate with estrogen and progestin in certain oral contraceptive pills?

<p>To reduce the risk of fetal neural tube defects (C)</p> Signup and view all the answers

What unique components does Natazia contain?

<p>Estradiol valerate and dienogest (B)</p> Signup and view all the answers

Which oral contraceptive pill component does not cause potassium retention?

<p>Estradiol valerate (A)</p> Signup and view all the answers

What is the onset of success within 21 days after taking Next Choice emergency contraceptive pills?

<p>Onset of menses (A)</p> Signup and view all the answers

Which component is common in all Selective Estrogen Receptor Modulators (SERMs)?

<p>Variable estrogen receptor activity in different tissues (B)</p> Signup and view all the answers

What was the main reason for developing Selective Estrogen Receptor Modulators (SERMs)?

<p>To selectively target estrogen receptors in different tissues (B)</p> Signup and view all the answers

'Duavee' is a combination drug used for what purpose?

<p>'Menopause hormone therapy' (A)</p> Signup and view all the answers

'Premature epiphyseal closure' is a potential side effect associated with the therapeutic use of which hormone?

<p>'Testosterone' (D)</p> Signup and view all the answers

'Edema caused from retention of salt and water' is a known side effect of which hormone therapy?

<p>'Testosterone' (C)</p> Signup and view all the answers

'Reducing HDL and increasing LDL cholesterol levels' is an adverse effect known for which therapy?

<p>'Testosterone' therapy (B)</p> Signup and view all the answers

What is the primary route of excretion for Methimazole?

<p>Urine (C)</p> Signup and view all the answers

In a person with a Sulfa allergy, which medication should be used with caution?

<p>Meglitinides (C)</p> Signup and view all the answers

What is the most common adverse effect associated with the use of alpha-glucosidase inhibitors?

<p>GI upset (A)</p> Signup and view all the answers

For an elderly person compared to a young adult, what is the approximate difference in the Levothyroxine dose needed?

<p>75% less (B)</p> Signup and view all the answers

Which medication should be monitored for ALT levels?

<p>Thiazolidinediones (A)</p> Signup and view all the answers

What is the main reason women discontinue progestin-only pills?

<p>Breakthrough bleeding (D)</p> Signup and view all the answers

What is the mechanism of action of alpha adrenergic agents?

<p>Blockade of alpha 1 receptors and relaxation of smooth muscle (A)</p> Signup and view all the answers

What is not a possible side effect of Testosterone therapy?

<p>Hair loss (C)</p> Signup and view all the answers

What should John, a type 1 diabetic having his wisdom teeth removed, do with his insulin regime?

<p>Continue the glargine and take lispro only as a supplement (A)</p> Signup and view all the answers

What is the effect of iodine on the thyroid gland?

<p>Stimulates thyroid hormone production (C)</p> Signup and view all the answers

Which drug is specifically mentioned to not activate estrogen receptors in the endometrium?

<p>Raloxifene (C)</p> Signup and view all the answers

What is the principal difference between tamoxifen and raloxifene?

<p>Raloxifene activates estrogen (B)</p> Signup and view all the answers

Which drug combines estrogen with an estrogen agonist/antagonist?

<p>Duavee (B)</p> Signup and view all the answers

What is the primary noncontraceptive use of progestins?

<p>Counteracting adverse effects of estrogen on the endometrium (C)</p> Signup and view all the answers

What are the adverse effects associated with progesterone use?

<p>Gynecologic effects and breast cancer (C)</p> Signup and view all the answers

Which drug produces hot flashes due to blocking estrogen receptors?

<p>[Nolvadex] Tamoxifen (B)</p> Signup and view all the answers

What is the purpose of cyclic therapy in the treatment of dysfunctional uterine bleeding?

<p>To establish a regular monthly cycle (A)</p> Signup and view all the answers

Which progestin can induce menstrual flow in selected women experiencing amenorrhea?

<p>[Provera] Medroxyprogesterone acetate (D)</p> Signup and view all the answers

Which hormone helps maintain the uterus throughout pregnancy?

<p>Progesterone (C)</p> Signup and view all the answers

What is a significant risk associated with receptor activation by tamoxifen?

<p>Endometrial cancer risk (D)</p> Signup and view all the answers

Which progestin is specifically approved for preventing preterm birth in women with a singleton pregnancy and a history of preterm delivery?

<p>Makena (A)</p> Signup and view all the answers

What is the purpose of a progestin in hormone therapy when used in combination with estrogen?

<p>Counterbalance estrogen-mediated endometrial stimulation (D)</p> Signup and view all the answers

Which medication was specifically highlighted for the treatment of vasomotor symptoms in menopause?

<p>Brisdelle (B)</p> Signup and view all the answers

What condition can endometrial hyperplasia potentially lead to?

<p>Endometrial carcinoma (D)</p> Signup and view all the answers

For which condition should nonestrogen treatments be considered carefully before prescribing hormone therapy?

<p>Preventing osteoporosis (D)</p> Signup and view all the answers

What is the main reason for including a progestin in estrogen/progestin therapy (EPT)?

<p>Addressing endometrial hyperplasia risk (C)</p> Signup and view all the answers

Which hormone therapy indication requires reassessment of continued therapy due to symptom subsiding over time?

<p>Treatment of vasomotor symptoms (C)</p> Signup and view all the answers

Which antidepressant was specifically mentioned for reducing the frequency and severity of hot flashes?

<p>Lexapro (A)</p> Signup and view all the answers

What is the key reason for using physiologic doses of estrogen in hormone therapy?

<p>To counteract proliferative effects of estrogen (B)</p> Signup and view all the answers

What should be avoided in hormone therapy according to the text?

<p>Long-term therapy (D)</p> Signup and view all the answers

What is the ratio of levothyroxine to liothyronine in Armour?

<p>5:1 (D)</p> Signup and view all the answers

What is the therapeutic use of Methimazole and Propylthiouracil?

<p>Treatment of hyperthyroidism (B)</p> Signup and view all the answers

What is the main effect of Radioactive Iodine on the thyroid?

<p>Destruction of thyroid tissue (A)</p> Signup and view all the answers

What is the diagnostic use of Radioactive Iodine?

<p>Diagnosis of hyperthyroidism (D)</p> Signup and view all the answers

What are the metabolic actions of Estrogen mentioned in the text?

<p>Enhancement of insulin sensitivity (C)</p> Signup and view all the answers

What adverse effect is associated with Estrogen therapy?

<p>Growth promotion of existing breast cancer cells (C)</p> Signup and view all the answers

In what noncontraceptive use is estrogen most commonly used postmenopause?

<p>Menopausal hormone therapy (A)</p> Signup and view all the answers

What route of administration is NOT mentioned for Estrogen in the text?

<p>Sublingual (D)</p> Signup and view all the answers

What is the peak duration of Glulisine (Apidra) insulin?

<p>0.75-1 hour (A)</p> Signup and view all the answers

Which insulin medication comes in 10 ml vials with 1000 units per 28 days after opening?

<p>NPH (C)</p> Signup and view all the answers

What technology do insulin pumps use to account for basal insulin needs throughout the day?

<p>Basal insulin infusion (A)</p> Signup and view all the answers

Why is it advised to counsel patients on the specific needles required for U-500 insulin?

<p>To prevent overdosing on insulin (C)</p> Signup and view all the answers

What is the main reason for refrigerating insulin medications until opening?

<p>To prevent the breakdown of proteins (A)</p> Signup and view all the answers

In giving insulin shots, why is it important to hold for 5-10 seconds after injecting?

<p>To ensure all medication is given (C)</p> Signup and view all the answers

What is the primary mechanism of action of Metformin?

<p>Reducing hepatic glucose output (A)</p> Signup and view all the answers

What is the most common adverse effect of Metformin?

<p>Vitamin B12 deficiency (A)</p> Signup and view all the answers

Which diabetic medication is associated with Lipoatrophy?

<p>Sulfonylureas (A)</p> Signup and view all the answers

What is the primary adverse effect that can result from metformin accumulation in patients with severe renal or liver disease?

<p>Lactic acidosis (C)</p> Signup and view all the answers

Which oral antidiabetic class of drugs is associated with weight loss rather than weight gain?

<p>SGLT-2 inhibitors (A)</p> Signup and view all the answers

How does Sulfonylureas induce insulin release in the body?

<p>By depolarizing cells and promoting insulin release (B)</p> Signup and view all the answers

What is the main difference between Lipoatrophy and Lipohypertrophy?

<p>Lipoatrophy involves fat loss around injection sites, while Lipohypertrophy involves fat accumulation. (D)</p> Signup and view all the answers

Which diabetic medication is considered a first-line therapy?

<p>Metformin (C)</p> Signup and view all the answers

What should be counseled to a patient experiencing severe gastrointestinal disturbances with Metformin?

<p>To titrate up to the required dose gradually. (B)</p> Signup and view all the answers

What is the action patients should take 48 hours prior to undergoing a contrast dye procedure while on Metformin?

<p>Discontinue the use of Metformin. (B)</p> Signup and view all the answers

What is the key reason behind the inclusion of levomefolate in Beyaz and Safyral oral contraceptive pills?

<p>To reduce the risk of fetal neural tube defects if pregnancy occurs (C)</p> Signup and view all the answers

What distinguishes Natazia from other combination oral contraceptives in terms of its components?

<p>It has a unique progestin component called dienogest (A)</p> Signup and view all the answers

What is the primary advantage of Natazia over other combination oral contraceptives?

<p>Does not induce potassium retention (B)</p> Signup and view all the answers

When administering Estrogen-progestin contraceptives, what should be done 1 to 2 hours before each dose?

<p>Administer an antiemetic (A)</p> Signup and view all the answers

Which component in Natazia is responsible for undergoing rapid conversion to the predominant endogenous estrogen?

<p>Estradiol valerate (B)</p> Signup and view all the answers

What distinguishes Estradiol/levonorgestrel from other combination oral contraceptives?

<p>Requires a Yuzpe regimen with 2 tablets q12h (A)</p> Signup and view all the answers

What is the recommended action if a patient misses 1 or 2 oral contraceptive pills during the second or third week of the pack?

<p>Take one pill as soon as possible and then continue with the active pills but skip the placebo pills. (D)</p> Signup and view all the answers

Which antibiotic is NOT listed as decreasing the effectiveness of oral contraceptives?

<p>Ciprofloxacin (C)</p> Signup and view all the answers

What is the follow-up recommendation for patients who initiate all methods of contraception?

<p>Pelvic exam, Pap smear, and STI testing 2 to 3 months post-initiation. (D)</p> Signup and view all the answers

What is essential for a patient using a diaphragm to do prior to each use?

<p>Inspecting the device (C)</p> Signup and view all the answers

Which contraceptive method has a potential complication related to site reactions including pain, bleeding, and infection?

<p>Injectables (B)</p> Signup and view all the answers

What is the recommended monitoring action for patients on estrogen-containing methods of contraception?

<p>Monthly blood pressure checks (D)</p> Signup and view all the answers

What should be done if a diaphragm is placed more than 6 hours before intercourse?

<p>Apply new spermicide before intercourse (C)</p> Signup and view all the answers

'St.John’s wort may alter estrogen levels, reducing efficacy or causing breakthrough bleeding.' What type of contraception is most likely affected by this interaction?

<p>&quot;The pill&quot; (A)</p> Signup and view all the answers

What could be an outcome if a patient with an IUD becomes pregnant?

<p>Higher likelihood of ectopic pregnancy (D)</p> Signup and view all the answers

What is the recommended procedure for a patient who misses several contraceptive pills during the second or third week of the pack?

<p>Follow instructions for one or two missed pills and use additional contraception for 7 days (B)</p> Signup and view all the answers

What is the initial recommended treatment approach for type 2 diabetes according to the position statement?

<p>Start lifestyle changes and metformin (C)</p> Signup and view all the answers

In the treatment of type 2 diabetes, when should a three-drug combination regimen be considered?

<p>If the patient does not achieve goals with two drugs (A)</p> Signup and view all the answers

Which of the following drugs is NOT mentioned as a potential second drug to add in step 2 of the treatment approach?

<p>Metformin (D)</p> Signup and view all the answers

According to the recommendations, what should be added if a three-drug combination inclusive of basal insulin fails to achieve treatment goals?

<p>GLP-1 receptor agonist (D)</p> Signup and view all the answers

When should SGLT-2 inhibitors be avoided in patients according to the text?

<p>When GFR is low (D)</p> Signup and view all the answers

If a patient with type 2 diabetes has been on a three-drug combination regimen for 4 months without achieving treatment goals, what is the next recommended step?

<p>Initiate a combination injectable regimen inclusive of insulin and possibly a GLP-1 receptor agonist (B)</p> Signup and view all the answers

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