MKSAP: 54-year-old woman asking advice about bone health

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 54-year-old woman comes to the office for advice regarding maintaining bone health. She has no history of fracture. The patient recently had a lumpectomy and radiation therapy to treat breast cancer, is currently taking tamoxifen, and will begin taking an aromatase inhibitor in 2 months. She underwent menopause at age 52 years and has persistent hot flushes. Her risk factors for osteoporosis include a slim body habitus and a mother who had a hip fracture at age 67 years. Physical examination findings, including vital signs, are normal. BMI is 20. Results of routine laboratory studies are normal. A dual-energy x-ray absorptiometry scan shows T-scores of −2.1 in the lumbar spine, −2.3 in the femoral neck, and −1.9 in the total hip. Her Fracture Risk Assessment Tool (FRAX) score indicates a 22% risk of major osteoporotic fracture and a 2.4% risk of hip fracture over the next 10 years. Optimal calcium and vitamin D supplementation is recommended, and she is encouraged to begin weight-bearing exercise as tolerated. Which of the following pharmacologic agents can be started in this patient? A: Alendronate B: Denosumab C: Estrogen D: Raloxifene E: Teriparatide Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.
Source: Kevin, M.D. - Medical Weblog - Category: Journals (General) Authors: Tags: Conditions Endocrinology Source Type: blogs