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Home > CME > Courses
Vitamin D Suffiency -
Assessment and Management

Presented by the University of Alabama School of Medicine
Division of Continuing Medical Education

Release Date: January 4, 2011
Expiration Date: January 4, 2014

Target Audience
Objectives
Source
CME Participation
Accreditation & Credit

Introduction
Case 1
Case Question #1
References and Resources

TARGET AUDIENCE:
Primary care physicians

OBJECTIVES:
Upon completion of this CME activity, participants should be able to:
  1. Describe the biologically active forms of Vitamin D and their skeletal effects.
  2. Explain the current controversy regarding Vitamin D suffiency and insufficiency.
  3. Identify common risk factors for Vitamin D insufficiency
  4. Describe appropriate treatment approaches for addressing Vitamin D insufficiency and deficiency.
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SOURCE:
FACULTY:

Amy Warriner, MD
Assistant Professor
Division of Endocrinology, Diabetes and Metabolism
University of Alabama School of Medicine, UAB
Birmingham, Alabama

Beret Casey, MD
Resident, Internal Medicine
University of Alabama School of Medicine, UAB
Birmingham, Alabama

Jeffrey R. Curtis, MD, MS, MPH
Associate Professor of Medicine
Co-Director, UAB Center for Education and Research on Therapeutics
Director, UAB Arthritis Clinical Intervention Program
Department of Medicine, Division of Immunology and Rheumatology
University of Alabama School of Medicine, UAB
Birmingham, Alabama

Allyson McDonough, MD
Medical Director, Round Rock Rheumatology and Infusion Center
Scott and White Medical Center
Round Rock, TX

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DISCLOSURE:
The faculty has no commercial affiliations to disclose.

Because of the nature of preliminary studies, some products mentioned are unlabeled and investigational. Dosages, indications, and methods of use of drugs mentioned in this publication may reflect the experience of the authors, clinical literature, or other resources. Therefore, please see the full prescribing information before using any licensed product mentioned.

CME PARTICIPATION:
To participate in this online course for CME credit, please review the objectives before beginning the program. Complete the course and the self-assessment test before January 4, 2014 to receive CME credit. Your certificate will then be available online. This process should take approximately 1 hour.
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ACCREDITATION:

The University of Alabama School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The University of Alabama School of Medicine designates this enduring material for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The boards of nursing in many states, including Alabama, recognize Category 1 continuing medical education courses as acceptable activities for the renewal of license to practice nursing.

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DISCLAIMER:
Dosages, indications, and methods of use of any drug referred to in this publication may reflect the clinical experience of the authors, clinical literature, or other clinical resources. Therefore, please see the full prescribing information before using any product mentioned. UAB is an equal opportunity/affirmative action institution.
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INTRODUCTION:

Osteoporosis is the most common bone disease with over half of women and a quarter of men over the age of 50 estimated to experience an osteoporosis-related fracture [1]. Current therapies are very effective at preventing fractures and reducing the risk of future fractures following an incident fracture. Aging and menopause are considered the primary risk factors for osteoporosis but many secondary causes exist and should be evaluated for based on the clinical assessment [2]. Vitamin D insufficiency is one of these secondary conditions that can both precipitate and exacerbate osteoporosis.

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Case:

You have been caring for a pleasant 75-year-old female nursing home resident for several years. Her medical history includes mild Alzheimer's dementia, COPD, and type 2 diabetes mellitus. She is currently taking theophylline and metformin. She avoids milk because of lactose intolerance. Over the past several months she has been complaining of generalized achiness and depressed mood. Physical exam reveals mild kyphosis. Initial lab work shows normal CBC, normal TSH, mild renal insufficiency (creatinine clearance of 65cc/minute), and normal serum calcium. Central dual-energy x-ray absorptiometry (DXA) shows that the lumbar spine T score is -3.0 and the total Hip T score is -2.4, which is consistent with osteoporosis.

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Question 1 of 5 - WORK-UP IN PATIENT WITH NEW OSTEOPOROSIS DX

1. What further work-up is indicated based on your findings thus far?

A. No further work-up is needed, start a bisphosphonate such as Boniva.
B. Check a 25-hydroxy (25-OH) Vitamin D level.
C. Geriatric psychiatry consultation to evaluate and treat her depression.
D. Bone scan to identify occult fracture


 

 
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