Osteoporosis: ABFM practice questions

16 board-style questions on osteoporosis in the PulseMD family medicine question bank, written against current guidelines with the reference cited on each question. Two free samples below; the full set with answers, explanations, and spaced review is free to start.

Sample question 1

A 65-year-old postmenopausal woman undergoes DEXA scanning. Her T-score is -2.8 at the lumbar spine and -2.3 at the femoral neck. She has no history of fractures. She takes calcium 1200 mg and vitamin D 1000 IU daily. Her 25-hydroxyvitamin D level is 32 ng/mL, and renal function is normal. What is the most appropriate pharmacologic treatment?

  1. Teriparatide 20 mcg daily
  2. Alendronate 70 mg weekly
  3. Raloxifene 60 mg daily
  4. Increase calcium to 1500 mg daily

Sample question 2

A 68-year-old woman undergoes her first DEXA scan. Results show a lumbar spine T-score of -1.8 and a femoral neck T-score of -2.3. She has no history of fragility fractures. Her FRAX 10-year probability of major osteoporotic fracture is 22% and hip fracture is 4.5%. She takes no medications and has adequate calcium and vitamin D intake. Her renal function and serum calcium are normal. What is the most appropriate management?

  1. Recommend weight-bearing exercise and calcium/vitamin D supplementation only
  2. Reassure and repeat DEXA in 2 years since T-scores are in the osteopenic range
  3. Initiate pharmacologic therapy with a bisphosphonate
  4. Order additional imaging with quantitative CT to confirm diagnosis before treating

Create a free PulseMD account to answer these, see the explanations, and practice five minutes a day.

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