QuestionSBA
QuestionChoice
Denosumab is a monoclonal antibody which inhibits the maturation of osteoclasts. It may be considered in the later stages of osteoporosis management.
10002458
b
Start denosumab
QuestionChoice
As this patient is older than 75 years of age, bisphosphonate treatment can be commenced without the need for a DEXA scan.
10002460
d
Perform a DEXA scan before starting treatment
QuestionChoice
As this patient is above the age of 75 years, any fragility fractures which occur should be attributed to underlying osteoporosis. The first-line therapy for this is an oral bisphosphonate (e.g. alendronic acid), which should help to reduce the risk of further fractures by inhibiting osteoclast activity.
10002457
a
Start oral alendronic acid
QuestionChoice
Raloxifene is a selective oestrogen receptor modulator which helps to reduce the risk of vertebral fractures. It may be considered in some cases of osteoporosis, however, bisphosphonates are still the first-line medical management.
10002461
e
Start raloxifene
QuestionChoice
Although hormone replacement therapy may be considered in the later stages of osteoporosis, bisphosphonates are the first-line medical therapy.
10002459
c
Start hormone replacement therapy
Concept
Chapter
2693
4041
Osteoporosis
Topic
190
Musculoskeletal
13038
An 80-year-old female on the geriatric ward is recovering from a fragility fracture which occurred 3 days ago. She has a past medical history of hypertension and COPD, for which she takes amlodipine, ramipril and salbutamol.

Which of the following options should be considered next in the management of this patient?
a