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Parathyroid hormone in osteoporosis - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Excellent Posted in: General Health
Answered by

General & Family Physician
Practicing since : 2004
Answered : 1777 Questions
Doctor :   hi
User :   hello
Doctor :   how can i help you
User :   i have a question regarding PTH
Doctor :   age, gender
Doctor :   ok
User :   why in low doses can it be used for osteoporosis
User :   when it takes calcium out of the bone
Doctor :   pth is hormone is prscribed by any doctor to you
User :   no
User :   i just want to know how thats possible
Doctor :   it cannot be done, unless ure examined
User :   i dont need it
User :   im asking you how it can be used for treatment of osteoporosis
Doctor :   then is any one has osteoporsis
User :   if it takes calcium out of the bone and into the blood
User :   its doing research
User :   im doing research
Doctor :   ok, theotically it stabilises the blood calcium
User :   but wouldnt it take calcium out of the bone
Doctor :   but, osteoporosis is less calcium in bone
User :   ok
User :   so your saying with people who have osteoporosis
Doctor :   yes, it takes out,it will cause more porosis
User :   PTH has less osteoclastic activity
User :   so then if it takes it out
User :   how can pth in low doses be used for osteoporosis
Doctor :   pth has one more action, it decreases the excreation of calcium from kidney
Doctor :   so the blood calcium is stabilised
User :   ok
Doctor :   inturn it may help to deposit in the bone
Doctor :   so in very low doses it may help
User :   so when u have such bad osteoporosis, pth activates blast?
Doctor :   exactlly in low doses it may, to maintain the homeostasis
Doctor :   but ,i think its in research level
User :   ah
User :   ok
Doctor :   its not prescribed routinely
User :   then i have a question regarding etidronate
Doctor :   ok,intesting
User :   it (-) vit d3 formation i understand that, but doesnt vit D increase your calcitrial, and decrease your excretion, so how does that play a role with hyperparathroidism
User :   especially since the issue with hyperparathroidism is mainly pth
User :   just by the fact that you stop the increase in calcitrial from the pth action too?
Doctor :   calcitriol increses the excreation of calcium from the body
User :   i thought it increass the GI absorption
Doctor :   in hypertyriodism , calium is more in blood,so calcitrol is helpful
Doctor :   calcium is balanced by 3 mechanism
User :   but PTH as a whole, you release ca+2 from the bone, giving you the hypercalcemia, but you also increase it in the blood by increasing the absorption of it throught the GIT, isnt that done by calcitriol
Doctor :   one is absorption by gi, 2 nd by excreation by kidney,and dipositing or withdrawing from bone
User :   so the absorpton of it throught GI isnt that done through calcitrio
User :   and obviously the TAL
User :   in the kidneys
Doctor :   calcitiol does opposite action of pth and vit D
Doctor :   are you there
User :   but its a form of Vitamin D3
User :   It increases gastrointestinal calcium absorption, stimulates osteoclastic calcium resorption from bone, facilitates the effect parathyroid hormone
Doctor :   ok,
User :   so ok i guess ill skip that question, um then with regards to lactoferrin
User :   what role does that play with staph
Doctor :   but pth and calcitriol have opposite action
User :   sorry for these questions
User :   im in med school
User :   haha im not insane i promise
Doctor :   it has anti bacterial activiy,mainly found in milk
Doctor :   so it inhibits stap growth
Doctor :   thats nice, which year are you in
User :   finishing my second year
User :   doing micro, pharm, and path right now
User :   and path is really really hard
Doctor :   see we are disscusing, ok what i remmember i am telling you
Doctor :   what you want in path
Doctor :   which college are you in
User :   University of chicago
Doctor :   and calcium metabolism is very intersting and important for exams
User :   what kind of doctor are you?
Doctor :   i am a dermatologist
User :   thats very cool
Doctor :   ok, my memory of pharm is long remote one
User :   haha its ok
User :   you have been very helpful
Doctor :   tats ok, any time you can log in , any quires, all the best for your studies
User :   so question, this is a micro question do you ever deal with pseduomonas aeruginosa?
Doctor :   yes,
Doctor :   yes we get lot ofcases
User :   does it usually come from something like tinea pedis?
Doctor :   why
Doctor :   tenia is afungal infection
User :   yeah
User :   but can that be a secondary inection
User :   becuase of the pedis's skin damage?
Doctor :   it can be secondary after longterm use of antibiotics
User :   ok
User :   whats that alginate
User :   what is that
Doctor :   AAAAAAA this is Dr AAAAAAA here
User :   hi dr. AAAAAAA
Doctor :   i a skin specialist
Doctor :   please proceed
User :   i had a question, im in med school, and im studying pseudomonas aeruginosa
Doctor :   ok
User :   i was wondering if thats a common 2ndary form somthing like tinea pedis
Doctor :   i wil help u in this
Doctor :   Tinea pedis is a fungal infection of the toes and intertrigenous area
Doctor :   usaally occurs in the following induviduals
Doctor :   risk factors are
Doctor :   1. diabetes
Doctor :   2. patients on broad spectrum antibiotics
Doctor :   3. immunocompromised induviduals
Doctor :   like HIV and those on steroids and immunosupressives
Doctor :   4. and induviduals who spend more time in water
Doctor :   Psuedomonas is a bacteria
User :   yeah i know
User :   but can it be a possible secondary
Doctor :   which causes most of secondary
User :   ok
Doctor :   infection
User :   what is alginate
Doctor :   particulary in diabetics, alcoholic, and old age group
Doctor :   Alginate is gel or cellular material from brown algae
User :   does that develope from aeruginosa
Doctor :   no it is gel material from brown algea
Doctor :   it does not develop from aeruginosa
User :   so whats the mucoid exopolysaccharide slime from aeruginosa called
Doctor :   yes aeruginosa also produces alginate
User :   ok
Doctor :   plays a role in the adhesion of bacterium to epithelial cell surfaces
User :   ok
User :   does lactoferrin help with that
Doctor :   this alginate is also produced by other organsims
Doctor :   like acetobacter
User :   so they both have acetate in common
User :   is that why they both --> alginate
Doctor :   yes
Doctor :   you are right
User :   ok
User :   thank you very much dr.
Doctor :   lactoferrin
User :   doesnt that just take up the iron so that the bactieria cant utilize it?
Doctor :   Pseudomonas aeruginosa promoted when the strain was cultured in an iron-depleted succinate medium, supplemented with transferrin and lactoferrin iron-saturation.
Doctor :   Lower lactoferrin iron saturation (
Doctor :   so lactoferrin is essential ingredient for the growth of the bacteria
Doctor :   lactoferrin at 60% and 100% at iron-saturation is ideal for the growth of bacteria
Doctor :   are yu there??????
User :   i thought lactoferrin was somthing that inhibits the growth of bacteria
User :   it prevents the growth
User :   by stealing its iron
Doctor :   this is lactoferrin in relation to pseudomas
User :   ok
User :   gotcha
User :   what does the bacillus genus natural flora do for us?
User :   like where is it located
Doctor :   when yu take general lactoferrin is protein found in milk, colustrum, tears,
User :   the only bascillis i know is antrhax
Doctor :   and other secretions
User :   ok
Doctor :   which helps in defensive mechanism
Doctor :   its inhibits the adhesion of the bacteria and viruses to the host epitheilal cells
Doctor :   it has antibacterial, antiviral and antifungal activity
User :   ok
Doctor :   are yu taking about Lactobacillus
Doctor :   The most common application of Lactobacillus is industrial, specifically for dairy production.
User :   actually i guess that makes sense
User :   what about neisseria
Doctor :   Neisseria is gram postive cocci
User :   i thought it was grm -
Doctor :   wat yu want to know about Neisseria
User :   it can be natural flora also
User :   so is that a opertunisitic bacteria
User :   and if you have lower other flora
Doctor :   yes it can be normal flora in gential mucous membarne
User :   can give u gonorrhea
Doctor :   yes you are right AAAAAAA
Doctor :   it causes opputusinistic infection
User :   ok
Doctor :   when immune system is breached
User :   ok
User :   like on a steroid
Doctor :   steroids, immunosupressives, alchohol, bad vaginal hygeine
Doctor :   HIV and others
User :   and strep b
User :   isnt that seen in women
User :   vaginal
User :   is that from fecal to vaginal transmission?
Doctor :   Step B is common flora of mouth, skin, intestine and upper respiratory tract
Doctor :   so the vaginal transmission is not there
Doctor :   nor feco vaginal transmission
Doctor :   Strep. agalactiae is a species of the normal flora of the female urogenital tract and rectum.
Doctor :   transferred to a neonate passing through the birth canal and can cause serious group B streptococcal infection.
User :   but the b strepococci isnt seen in the vagina?
User :   of the baby or the mother
Doctor :   group A of beta hemolytic strep is Pharygitis, nephitis,
Doctor :   group B of beta hemolytic strep- agalactiae
Doctor :   S. agalactiae is a major cause of bacterial septicemia of the newborn
User :   ok
Doctor :   neonatal meningitis
User :   so therefore when you said that strep agalactia is see in the rectum
User :   and thats a type b
Doctor :   group c of beta hemolytic strep
User :   that had to have been transmitted fecal to vaginal
Doctor :   is Equi
Doctor :   it infects cattle and horses
User :   hence the baby getting it from delivery
User :   right?
Doctor :   its vaginal and rectum
User :   ok
User :   so its not from the rectum to the vagina
Doctor :   mainly female urogenital tract
User :   they both have it
User :   ok
Doctor :   transferred to a neonate through the birth canal
User :   so do women (post menapausal) have a higher right of vaginal infections
Doctor :   yes post menopausal women has high risk for vaginal infection
Doctor :   due
Doctor :   1. senile vaginaitis
User :   to the flora that requires estrogen
Doctor :   2. loss of estrogen
User :   the lactobacillis
Doctor :   3. loss of normal flora like doderline bacillus
User :   can u get q fever from rickettsia
Doctor :   Yes yu get fever from Rickettsia
Doctor :   A self limiting condition that is transmitted by mites
Doctor :   it causes
Doctor :   1. R. typhus
Doctor :   2. Q fever
User :   rocky mountain spotted fever?
Doctor :   3. Rocky mountain spotted fever
User :   cool
User :   what is psittacosis
Doctor :   Rocky mountain spotted fever - Rikecttsia rickettsie
Doctor :   psittacosis - chlamydia psittachai
User :   can u treat that with tetracycline?
Doctor :   its also called parrot fever, spreads by bird dropping
User :   but that a bacteriostatic
User :   would that suffice?
Doctor :   treat ment is Tetracycline
Doctor :   Doxycycline
User :   what about chloramphenicol
Doctor :   Ricketssia and chlamydia does not respond to other antibioitic
Doctor :   chloramphenicol can be used but has more side effects on bone marrow
Doctor :   so ideal is to go for Doxycyline
User :   what about neomycin
User :   or gentamicin
User :   less toxic
User :   but then theres the cn8 issues
Doctor :   Its a gut antibiotic
User :   then how about macrolides
Doctor :   the mechanism of action of tetracycyline
User :   like a erythromycin
Doctor :   inhibit bacterial protein synthesis by blocking the attachment of the transfer RNA-amino acid to the ribosome.
User :   ok
User :   if you had toxoplasma dondill
Doctor :   so tetracyclines can penetarate the chlymadia and rickettisa
User :   would azithromycin work?
User :   gontil*
User :   gondil*
Doctor :   yes toxoplama - azithromycin or macrolides
Doctor :   but pregnancy - its spiramycin the drug of choice
User :   now what about linezolids
User :   for MRSA?
Doctor :   Linezolids are used if vancomycin is resistant
Doctor :   For MRSA vancomycin is the drug of choice
Doctor :   but if vancomycin is resistant then go for
User :   can you have VMRSA
Doctor :   linezolid
User :   ok
Doctor :   Quinopristone
Doctor :   Dalfipristone
User :   what about rifampicin'
User :   just for TB?
Doctor :   ideal drug for tubeculosis its bactericidal
User :   what about the wierd sweat color'
User :   is that dangerous
Doctor :   useful in acitve and rapid growers
Doctor :   has few side effects
Doctor :   like respiratory flu like
Doctor :   abdominal flu like
User :   you sweat orange
Doctor :   orange color urine
User :   ok
Doctor :   and hepatotoxic
Doctor :   dose need to be adjusted
User :   when would u use a trimethoprim
Doctor :   based on hepatotoxicity
Doctor :   ideal drug for Pnemocystis carinii pneumonia
User :   does that inhibit folic acid sythn?
Doctor :   bacterial dihydrofolate reductase (folate antagonist)
User :   ok
Doctor :   Please fill the feed back form
User :   i did
User :   thank you very much
Doctor :   thank you
User :   i really appreciate it
User :   sorry if i drove you crazy
Doctor :   Is there any thing else i can help u with
User :   no
Doctor :   no need for sorry
Doctor :   i have cleared your doubts AAAAAAA
User :   yes you have
Doctor :   its my pleasure and duty
User :   take care
Doctor :   ok take care bye for now
User :   bye
User :   whats ur name
User :   so i can request you
Doctor :   Me dr xxxx
User :   ok
User :   are you on alot or can i just ask for you?
Doctor :   yu can ask for me
User :   ok
Doctor :   there are also other doctors
User :   thank you Dr xxxx
User :   yes but you really know your stuff
Doctor :   working with me
Doctor :   ok
Doctor :   take care
Doctor :   Thanks for consulting Health care magic. Take care bye for now. Please refer your friends
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