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Questions and Answers

What is the mechanism of action of Allopurinol?

Increases urinary excretion of uric acid

Interrupts the breakdown of purines before uric acid is formed (correct)

Stimulates the production of uric acid

Inactivates the effects of uricosuric agents

Why is aspirin avoided in gout management?

It stimulates the production of uric acid

It inactivates the effects of uricosuric agents (correct)

It increases the risk of renal insufficiency

It decreases the absorption of Allopurinol

What is the primary goal of dietary management in gout?

To increase the intake of aspirin

To maintain a high calorie diet

To restrict the consumption of foods high in purines (correct)

To increase the consumption of foods high in purines

What is the purpose of bone density assessment in gout management?

To assess overall bone health status Signup and view all the answers

What is the role of corticosteroids in gout management?

They are used as a last resort in resistant cases Signup and view all the answers

What is Probenecid used for in gout management?

To increase the urinary excretion of uric acid Signup and view all the answers

What is the recommended frequency of consumption of foods high in purines?

These foods should be consumed occasionally Signup and view all the answers

How long does a DEXA test typically take to complete?

20 to 30 minutes Signup and view all the answers

What is the primary component of management for clients with gout?

Drug therapy Signup and view all the answers

What is the time frame for IV colchicine to take effect?

Within 12 hours Signup and view all the answers

How long does it take for inflammation to subside with oral medication?

4-7 days Signup and view all the answers

What percentage of a woman's bone mass is lost during her lifetime?

40-45% Signup and view all the answers

Which of the following bones are most often affected by osteoporosis?

Wrist, hip, and vertebral column Signup and view all the answers

What is osteoporosis often referred to as?

A silent disease Signup and view all the answers

What is the primary purpose of Hormone Replacement Therapy (HRT) in postmenopausal women?

To prevent bone loss and osteoporosis Signup and view all the answers

Which of the following foods is considered low in purines and safe to eat for individuals with gout?

Green vegetables Signup and view all the answers

What is the main mechanism of action of biphosphonates in terms of bone health?

Inhibiting bone resorption Signup and view all the answers

What is the recommended daily intake of vitamin D for optimal calcium absorption?

400-800 International Units/day Signup and view all the answers

Which of the following is a common side effect of teriparatide (Forteo) therapy?

Fatigue Signup and view all the answers

What is the purpose of calcium supplementation in the prevention of osteoporosis?

To promote bone health Signup and view all the answers

Which of the following dairy products may help lower the risk of gout?

Low-fat or skim milk Signup and view all the answers

What is the role of conjugated estrogens/medroxyprogesterone (Prempro, Premphase) in Hormone Replacement Therapy?

To reduce the risk of osteoporosis Signup and view all the answers

Study Notes

Gout Management

Uricosuric agents like Probenecid (Benemid, Benuryl) increase urinary excretion of uric acid and prevent tophi formation.
Allopurinol (Zyloprim) is the drug of choice for patients with or at risk of renal insufficiency or renal calculi; it inhibits xanthine oxidase, interrupting the breakdown of purines before uric acid is formed.
Aspirin is avoided as it inactivates the effects of the drug.
Corticosteroids may be used in resistant cases.

Diet and Gout

Purines are chemical compounds found in some foods that are broken down into uric acid.
Foods to limit (very high in purines):
- Beef
- Pork
- Lamb
- Seafood
- Yeast (used in beer and bread)
- Bacon
- Liver
Foods to eat occasionally (moderately high in purines, but may not raise the risk of gout):
- Chicken
- Duck
- Ham
- Turkey
- Kidney and lima beans
- Dairy products that may lower the risk of gout: low-fat or skim milk, low-fat yogurt
Foods that are safe to eat (low in purines):
- Green vegetables and tomatoes
- Fruits and fruit juices
- Breads and cereals that are not whole-grain
- Butter, buttermilk, cheese, and eggs
- Chocolate and cocoa
- Coffee, tea, and carbonated beverages
- Peanut butter and nuts

Osteoporosis

A metabolic disease characterized by bone demineralization, resulting in decreased density and subsequent fractures.
Bones become progressively porous, brittle, and fragile.
Often referred to as a “silent disease” because bone loss occurs without symptoms.
Most often affected bones: wrist, hip, vertebral column.
40-45% of a woman’s bone mass is lost during her lifetime.
Bone density (DEXA) measurements assess overall bone health status.
Bone density tests measure the bone mineral density (BMD) of both hips, the lumbar spine, and require 20-30 minutes for completion.

Management of Osteoporosis

Drug therapy: Hormone Replacement Therapy (HRT) has been used as a primary prevention strategy for reducing bone loss in postmenopausal women.
Conjugated estrogens/medroxyprogesterone (Prempro, Premphase) use is carefully evaluated by the healthcare provider and client.
PTH: approved treatment for both men and women, stimulates new bone formation, increasing BMD.
Calcium: important for bone health, but alone is not a treatment; OTC supplements like calcium carbonate (Tums/Oscal) and calcium citrate (Citracal) are used.
Vitamin D: essential for optimal calcium absorption in the intestines; 400-800 International Units/day.
Biphosphonates: inhibit bone resorption by binding with crystal elements in bone, especially spongy, trabecular bone tissue.
Treatment may include oral supplements of vitamin D, calcium, and phosphorus, depending on the underlying cause of the disorder.

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