QuestionSBA
QuestionChoice
Fundoscopy isn't routinely used to monitor for adverse effects of corticosteroid treatment
50410
b
Fundoscopy
QuestionChoice
Hepatic function monitoring isn't routinely used for corticosteroid treatment
50412
d
Liver function tests
QuestionChoice
Cardiac monitoring is not routinely used for corticosteroid treatment
50413
e
ECG
QuestionChoice
A chest x-ray isn't routinely used to monitor for adverse effects of corticosteroid treatment
50411
c
Chest X-ray
QuestionChoice
Prolonged steroid treatment is linked with growth alterations. Paediatric patients are likely to weigh more and have a reduced height if they are taking steroids for a prolonged time. Any slowing in growth should prompt a referral to a paediatrician
50409
a
Height and weight
QuestionComment
bnf says need to regularly check for cataracts and glaucoma - so fundoscopy should be correct?
40276
QuestionComment
fundoscopy looks at the back of the eye. I think you can see the beginnings of a cataract with the naked eye  
40312
User
subscriber
Neoplasia Nightshift
User
subscriber
aaaaa
Concept
Chapter
Osteoporosis, otherwise known as thin bones, is a condition associated with high risk of low trauma fractures due to reduced bone mineral density. Osteoclast activity exceeds osteoblast activity, meaning that bone resorption is occurring at a greater rate than bone formation.

**Symptoms and Signs**

- Generally asymptomatic until a fragility fracture occurs
- Back pain
- Kyphosis (stooped posture)
- Fragility fractures

**Risk factors**

- Female sex
- Increasing age
- Smoking
- Corticosteroid use
- Low BMI (< 20-25kg/m<sup>2</sup>)
- Low body weight (<58kg)
- Vitamin D deficiency

**Protective factors**

- Higher BMI
- Exercise - mechanical loading stimulates bone formation

**Diagnosis**
Osteoporosis can be detected on dual-energy x-ray absorptiometry (DEXA) scan.
A T score of < -2.5 indicates osteoporosis

**Management**

- Fall prevention
- Vitamin D and calcium supplementation
- Hormone replacement therapy (postmenopausal women)
- Oral bisphosphonates
2657
3665
Monitoring height and weight is required in children taking corticosteroids
Topic
91
Paediatrics
10136
Case Presentation: A 9-year-old girl is seen in the outpatient paediatrics with swollen, stiff and painful knees. This has been going on for the last 10 weeks.




 **Investigations**


Both knees are red in appearance. Both are swollen. Limited range of motion due to pain and stiffness.


ANA: +ve


Rheumatoid factor: +ve


CRP: 36 mg/L (< 5mg/L)


It is decided that she is likely suffering from juvenile idiopathic arthritis and requires treatment with ibuprofen, methotrexate and prednisolone.


Question: If she takes the prednisolone for a prolonged period of time, what parameters should be monitored?
a