Hip Fractures
What is the mortality rate at 1 year after a hip a fracture?
a. ~10%
b. ~20%
c. ~50%
The mortality rate after a hip fracture at 1 year is is 26.9% for men and 18.5% in women (USA), and 22% worldwide.
Causes of death: pneumonia, sepsis, MI, PE, cancer
Definition of secondary amenorrhea
Secondary amenorrhea: no menses for 3 months in previously regular, or 6 months in previously irregular
Primary: age 15 or 3 yrs after thelarche (breast development)
Oligomenorrhea: 35 days or more btw cycles in adults
- All 3 are approached the same
what medication can precipitate acute angle closure glaucoma
anti-cholinergic medications
how many servings of dairy is recommended daily for an adult?
3 servings of full fat dairy with no added sugar
This intern resident was born in Singapore
Janelle Stafford
Name 2 medications known to reduce bone mineral density?
SSRI
Pioglitazone
Steroids
Anastrozole
Leuprolide
What are the 6 initial labs for evaluation of amenorrhea?
Urine hcg
LH & FSH
Estradiol
Prolactin
TSH
foreign body sensation, unilateral watering, unilateral pain
corneal abrasion
how many servings of whole grains is recommended daily for an adult?
2 to 4 serving, minimally processed
This resident was a D1 college rower
Rebecca Praetzel
Early mobilization post-op and adequate pain control for early mobilization is recommended after a hip fracture. Is thromboprophylaxis recommended?
Yes- Thromboprophylaxis is recommended for all regardless if they undergo surgery.
What screening test should be ordered at the time of diagnosis of premature ovarian failure/functional HPA dysfunction?
Dexa scan for osteoporosis.
FYI- cOCP does not help bone health in premature ovarian failure/functional HPA dysfunction. It can cause menses, but this may mask recovery in this condition. It can be used for contraception because they may also have ovulation without menses.
headache, eye pain, jaw claudication
Giant Cell Arteritis
How much mg/kg of protein is recommended for an adult in a day?
1.2-1.6 mg/kg body weight per day
This resident was a mechanical engineer prior to becoming a physician
Vincent Brick
Hip FRAX score greater than or equal to ___ % is indication for treatment
>= 3% hip Frax score
In Polyendocrine Metabolic Ovarian Syndrome (PMOS), which lab should be ordered at Dx for screening, then every 3 years.
a1c
Episodic eye pain
Migraines
Keep added sugar below ___ grams per meal
Keep it less than 10g per meal
This resident's sister is a physician at St Vincent
Sanyam Sharma
Delay of even 1 month of this osteoporosis treatment/medication causes increase risk of vertebral fractures
Denosumab (Prolia).
- Mechanism of action: inhibits osteoclast activity through RANK-L. Delaying 1 month, causes rapid bone loss due to rapid turnover.
Which labs are affected by cOCPs use in last 3 months?
Free & total testosterone, DHEA-S
These are NOT part of the initial work up unless s/s hyperandrogenism in the history and physical
Pain with eye movement and subacute vision loss is a clue to this Dx
Optic Neuritis/Multiple Sclerosis
No caffeine or added sugar drinks recommended before this age
11 years old
This resident is talented in diamond art
Brianna Dudley