Postmenopausal Osteoporosis Guideline Quiz

A 70-year-old postmenopausal woman with severe osteoporosis (T-score < −2.5 and multiple vertebral fractures) presents to the clinic. Which of the following is recommended for her treatment?

Which of the following fractures has romosozumab been shown to reduce the risk of in clinical trials?

A 75-year-old woman with a history of cardiovascular disease presents with osteoporosis. Which of the following should NOT be considered in the management of her osteoporosis?

A 70-year-old woman with a history of osteoporosis has completed a course of romosozumab treatment. What is recommended for maintaining bone mineral density gains and reducing fracture risk?

A 65-year-old woman with severe osteoporosis (T-score < -2.5 and multiple vertebral fractures) is being evaluated for treatment. Which of the following is recommended as a first-line therapy?

Which of the following adverse events is associated with teriparatide and abaloparatide use?

Which of the following statements about patient adherence to denosumab treatment is true?

What is the recommended duration of treatment with teriparatide or abaloparatide?

What is the recommended dosing schedule for denosumab?

A 75-year-old woman has been taking denosumab for the past 6 years. Which of the following adverse events is a potential risk associated with cessation of denosumab?

A 70-year-old man with a history of chronic kidney disease (CKD) is being considered for treatment with denosumab. What is an essential consideration in the use of denosumab in this patient population?

A 65-year-old postmenopausal woman with osteoporosis is started on denosumab. Which of the following adverse events is a potential risk associated with this medication?

A 75-year-old woman has been taking denosumab for the past 6 years. She presents with signs and symptoms of hypocalcemia. What is the appropriate management of this patient?

A 57-year-old woman with a history of breast cancer is diagnosed with osteoporosis. She has never sustained a fragility fracture. DEXA score was significant for a T score of -2.6 in the left hip. Which of the following medications would be the most appropriate initial therapy for her?

A 72-year-old woman has been taking denosumab for 8 years. Which of the following is the most appropriate action for her treatment at this time?

A 65-year-old woman with a history of osteoporotic fractures is considering treatment options. She has chronic kidney disease (stage 3) and has been taking calcium and vitamin D supplements. Which of the following medications is safe and effective for this patient?

A 60-year-old woman with a BMD T-score of -3.0 at the hip and a history of hip fracture presents to your office for osteoporosis management. She has been on denosumab therapy for 2 years and has had no new fractures. Her BMD has increased by 7% at the lumbar spine and 5% at the hip since starting therapy (the Least Significant Change for your institution’s DEXA machine is 2.5%). What is the most appropriate management strategy for this patient?

Which of the following statements is true regarding the safety of romosozumab treatment in postmenopausal women?

Which of the following adverse events was observed during the romosozumab treatment period in the FRAME trial?

A 70-year-old woman with a history of vertebral fractures presents to your office for osteoporosis management. She has been on alendronate therapy for 3 years and has had no new fractures. Her BMD has increased by 5% at the lumbar spine and 3% at the hip since starting therapy (the Least Significant Change for your institution’s DEXA machine is 2.5%). What is the most appropriate management strategy for this patient?

A 65-year-old woman with a BMD T-score of -2.3 at the femoral neck and no history of fractures presents to your office for osteoporosis evaluation. What is the most appropriate management strategy for this patient?

A 70-year-old postmenopausal woman with osteoporosis and a history of heart disease cannot tolerate bisphosphonates, estrogen, or denosumab. Which therapy is recommended to prevent hip fractures?

A 70-year-old postmenopausal woman with osteoporosis and a history of breast cancer cannot tolerate bisphosphonates, denosumab, or raloxifene. Which therapy is recommended to prevent vertebral fractures?

A 58-year-old postmenopausal woman presents to the clinic with a history of osteoporosis and a T-score of -2.6 at the femoral neck. She has a low risk of DVT and has no contraindications for hormone therapy. She has been experiencing frequent hot flushes and night sweats, which are interfering with her sleep. She is concerned about the risk of breast cancer as she has a family history of the disease. Which of the following is the most appropriate treatment option for this patient to prevent vertebral and nonvertebral fractures?

A 55-year-old postmenopausal woman presents to the clinic with a history of hysterectomy due to uterine fibroids. She has a family history of osteoporosis and has been experiencing frequent hot flushes and night sweats, which are interfering with her sleep. Her bone mineral density (BMD) scan reveals a T-score of -2.5 at the femoral neck. She is at low risk of deep vein thrombosis (DVT) and has no contraindications for hormone therapy. Which of the following is the most appropriate treatment option for this patient to prevent all types of fractures?

A 75-year-old postmenopausal woman with osteoporosis and no history of breast cancer or DVT is interested in a medication to reduce the risk of future fractures. Which medication is NOT recommended to reduce the risk of vertebral fractures in this patient?

A 72-year-old postmenopausal woman with osteoporosis and a history of deep vein thrombosis (DVT) is at high risk of vertebral fractures. Which medication is NOT recommended to reduce the risk of vertebral fractures in this patient?

A 68-year-old postmenopausal woman with a history of breast cancer is at high risk of vertebral fractures. Which medication is recommended to reduce the risk of vertebral fractures?

A 60-year-old postmenopausal woman with osteoporosis has elevated serum calcium levels. Which of the following treatments should be avoided?

A 70-year-old postmenopausal woman with osteoporosis is concerned about the cost and inconvenience of daily injections. Which of the following treatments would be most appropriate for her?

A 55-year-old postmenopausal woman with osteoporosis has been on bisphosphonates but continues to lose bone mass. Which of the following treatments should be considered?

A 75-year-old postmenopausal woman with a history of hypoparathyroidism (well-controlled) who completed a course of teriparatide for osteoporosis is now concerned about maintaining her bone density gains. Which of the following treatments would be most appropriate for her?

A 65-year-old postmenopausal woman presents with a history of multiple vertebral fractures and is found to have osteoporosis. Which of the following treatments would be most appropriate for her?

A 70-year-old postmenopausal woman with osteoporosis has been taking denosumab for the past 5 years. Which of the following statements about denosumab is true in this patient?

A 65-year-old postmenopausal woman with osteoporosis is considering denosumab as a treatment option. Which of the following statements about denosumab is true?

What is the risk of hypocalcemia associated with denosumab?

What is the risk of stopping denosumab treatment without subsequent antiresorptive or other therapy?

How often should denosumab be administered in osteoporosis?

A 60-year-old postmenopausal woman presents with a BMD T-score of −2.2 at the femoral neck and no prior history of fractures. Her FRAX 10-year probability of a major osteoporotic fracture is 12%, and of a hip fracture is 2.5%. What is the most appropriate treatment for this patient?

A 70-year-old postmenopausal woman presented with a history of a vertebral fracture 2 years ago. Her BMD T-scores are −2.8 at the total hip and −2.6 at the lumbar spine. Her FRAX 10-year probability of a major osteoporotic fracture is 25%, and of a hip fracture is 8%. What is the most appropriate treatment for this patient?

What is the ASBMR Task Force recommendation regarding a bisphosphonate holiday?

When should postmenopausal women with osteoporosis who are taking bisphosphonates be considered for a “bisphosphonate holiday”?

What is the recommended initial treatment for postmenopausal women at high risk of fractures?

Who should be treated with pharmacological therapies for osteoporosis?

Which of the following bisphosphonates has been shown to reduce all clinical fractures in women and men after hip fracture?

Which of the following bisphosphonates is not recommended to reduce nonvertebral or hip fracture risk?

Which of the following is the most appropriate treatment for postmenopausal women at high risk of fractures?

Which of the following pharmacological therapies is recommended for postmenopausal women at high risk of fractures who have not responded to bisphosphonate therapy?

How long should a bisphosphonate holiday last in postmenopausal women with osteoporosis who have been taking bisphosphonates and remain at low-to-moderate risk of fractures?

Which of the following bisphosphonates is not recommended to reduce nonvertebral or hip fracture risk in postmenopausal women at high risk of fractures?

A postmenopausal woman with a recent vertebral fracture should be treated with pharmacological therapies to reduce fracture risk. Which of the following is true regarding treatment thresholds for osteoporosis in different countries?