Osteoporosis Treatment Options

What is the patient's height in centimeters?

172cm
175cm
170cm (correct)
168cm

What is the patient's weight in kilograms?

50 kg
58 kg
54 kg (correct)
60 kg

Why was the patient taking a nonsteroidal anti-inflammatory drug (NSAID)?

To relieve occasional back pain and stiffness (correct)
To treat gastroesophageal reflux disease
To improve her diet
To prevent osteoporosis

What is the patient's family history regarding osteoporosis?

Her mother and aunt have sustained osteoporotic fractures (A) Signup and view all the answers

What is the patient's T score at the spine?

-1.5 (A) Signup and view all the answers

Why was the patient referred for BMD testing?

According to the recommendations of the National Osteoporosis Foundation (C) Signup and view all the answers

What is indicated by her T-score?

Osteopenia (A) Signup and view all the answers

What is the purpose of the FRAX tool?

To assess the 10-year probability of hip and major osteoporotic fracture (C) Signup and view all the answers

Why is ibandronate not a suitable drug to manage her case?

It is only effective in reducing spine fracture risk (B) Signup and view all the answers

What is a risk factor for osteoporosis mentioned in the text?

Poor nutrition and low calcium intake (C) Signup and view all the answers

What is considered a high fracture risk according to FRAX?

≥ 3% for hip or ≥ 20% major OPF (A) Signup and view all the answers

What is a potential result of FRAX assessment in this patient?

High fracture risk (C) Signup and view all the answers

What is typically used to evaluate bone resorption during antiresorptive therapy?

Serum C-telopeptide of type I collagen (CTX) (B) Signup and view all the answers

What is the typical duration of treatment before considering a drug holiday?

3 years (A) Signup and view all the answers

Why is a drug holiday recommended after long-term bisphosphonate therapy?

To minimize the risk of osteonecrosis of the jaw and Atypical femur fractures (A) Signup and view all the answers

What is the effect of bisphosphonates on bone density after discontinuation?

The increased BMD is sustained for a prolonged period (C) Signup and view all the answers

What is the purpose of measuring bone turnover markers (BTMs) at 3-6 months after initiation of treatment?

To evaluate the efficacy of antiresorptive therapy (A) Signup and view all the answers

What is the recommended drug class for a patient with high fracture risk according to 2020 AACE/ACE guidelines?

Bisphosphonates and monoclonal antibodies (C) Signup and view all the answers

Why was the patient prescribed I.V bisphosphonates (zoledronic acid) instead of oral bisphosphonates?

Because the patient had GERD and oral bisphosphonates would worsen the condition (C) Signup and view all the answers

What is a common adverse effect of I.V bisphosphonates?

Fever and muscle aches (flu-like symptoms) (A) Signup and view all the answers

What is a possible way to evaluate therapeutic outcomes in patients with high fracture risk?

By asking patients about possible fracture symptoms (C) Signup and view all the answers

How often can central DXA BMD measurements be obtained for monitoring bone loss and treatment response?

Every 1 to 2 years (C) Signup and view all the answers

What is another possible adverse effect of I.V bisphosphonates?

Osteonecrosis of the jaw (ONJ) (D) Signup and view all the answers