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OSTEOPOROSIS DIAGNOSIS

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WHAT IS GOLD STANDARD? Dual energy X-ray absorptiometry (DXA) is the gold standard for diagnosis of osteoporosis. BUT DXA IS NOT ESSENTIAL TO START TREATMENT .

WHAT ARE THE ANTI-OSTEOPOROTIC THERAPIES AVAILABLE

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A Little Death In Dixie 1.CALCIUM AND VITAMIN D SUPPLEMENTATION 2.BISPHOPHONATES-?ACTIVE UPPER GI DISORDERS ARE CONTRAINDICATIONS 3.HORMONE THERAPY-?RISK OF THROMBOEMBOLISM 4.PARATHYROID HORMONE 5.SELECTIVE OESTROGEN RECEPTOR MODULATORS(SERM)-RISH SIMILAR TO HORMONE THERAPY(BUT REDUCES BREAST CANCER) 6.STRONTIUM RANELATE.

OSTEOPOROSIS IMPORTANT POINTS

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Osteoporosis is an A Little Death In Dixie asymptomatic process until afracture occurs. ■ Adults who have one fracture are 2-4 times more likely to have another. ■ Bone densitometry may not be essential before starting medical therapy if X-ray investigation shows one or more vertebral fractures typical of osteoporosis. ■ Most elderly people in highand low-level residency care have vitamin D deficiency.

Renal calculi -Important points

http://amcexams.blogspot.com/?spref=gb ■ Abdominal examination is most rewarding after ensuring adequate analgesia. ■ Plain KUB has a sensitivity of only 45-59% and a specificity as low as 77% – it cannot be used to rule in or rule out the diagnosis of ureteric calculi. ■ Infection with obstruction mandates urgent decompression. ■ There is evidence of permanent nephron loss within 72 hours of complete obstruction. ■ The likelihood of spontaneous stone passage is determined by stone size and position. ■ Fifteen to twenty per cent of all patients with ureteric calculi will require intervention using ESWL, ureteroscopy or percutaneous nephrolithotomy.

Renal calculi -indictions for early intervention

1.Obstruction with evidence of infection-urgent decompression. 2.larger calculi -more than 6mm 3.Bilateral obstruction. 4.An obstructed solitary or transplanted kidney. 5.Renal impairment.(review the definition of renal impairment) 6.Ongoing unacceptable discomfort.