QuestionSBA
QuestionChoice
Regular blood pressure monitoring is only required in patients receiving IV nitrates.
50366
c
He will need regular blood pressure monitoring
QuestionChoice
Regular heart monitoring is only required in patients receiving IV nitrates.
50367
d
He will need regular heart rate monitoring
QuestionChoice
GTN is administered sublingually (under the tongue), not into the buccal mucosa.
50368
e
He should administer his GTN spray into the buccal mucosa
QuestionChoice
Diarrhoea is an uncommon side effect of GTN therefore he is not likely to experience it.
50365
b
He is likely to experience diarrhoea when taking GTN
QuestionChoice
Dizziness is a very common side effect of GTN, therefore when taking GTN it is advised that patient's sit down so that they do not fall.
50364
a
He should sit down if possible when taking his GTN spray
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
3656
How to take GTN spray properly
Topic
9
Internal Medicine
10127
Case presentation: A 59-year-old man attends his GP complaining of chest pain. This chest pain is central, comes on with exercise and goes away with rest.






 **PH**
Hypertension


 **DH**
Ramipril 5mg PO OD


 **Investigations**


ECG - normal sinus rhythm


Troponin I 3 ng/L (<14 ng/L)


It is decided that this gentleman has stable angina and should be given GTN (glyceryl trinitrate) spray for symptomatic relief.


Question: Select the most important information that should be provided for this patient.
a