Osteoporosis: The Daily PANCE Blueprint
Which of the following is the best first-line treatment for a post-menopausal woman with osteoporosis and no pathological fractures?
A. Bisphosphonates
B. Parathyroid hormone analogs
C. RANKL inhibitors
D. Selective estrogen receptor modulators
E.Calcitonin
Answer and topic summary
The answer is A. Bisphosphonates
Osteoporosis is characterized by low bone mass and skeletal fragility leading to decreased bone strength. There are no clinical symptoms of osteoporosis until a patient has an actual fracture. Vertebral fractures in particular are the MOST common clinical manifestation of osteoporosis.
Diagnosis is made by a DEXA scan (T-score < -2.5 standard deviations) or a fragility fracture.
Lifestyle changes that can be made include exercise and cessation of smoking. The first-line pharmacological agent is oral bisphosphonates (e.g., alendronate or risedronate).
Remember bisphosphonates should be administered first thing in the AM and >30 min before the first food. Patients should stay upright for >30 minutes.
Smarty PANCE Content Blueprint Review:
Covered under ⇒ PANCE Blueprint Musculoskeletal ⇒ ⇒
Also covered as part of the Family Medicine EOR topic list
