osteoporosis

Practice targeted AMC-style multiple-choice questions on osteoporosis.

CT, ultrasonography, SPECT and scintigraphy of intra-thyroid parathyroid adenoma

Image by Mnahi Bin Saeedan, Ibtisam Musallam Aljohani, Ayman Omar Khushaim, Salwa Qasim Bukhari, Salahudin Tayeb Elnaas — CC BY 4.0 · Source

A 62-year-old woman with osteoporosis and a history of kidney stones presents with a serum calcium of 2.9 mmol/L (2.1-2.6 mmol/L) and PTH of 120 pg/mL (10-65 pg/mL). She denies neck pain or swelling. The provided imaging was obtained. What is the MOST appropriate next step?

A. Cinacalcet to lower PTH levels

B. Vitamin D and calcium supplementation

C. Surgical excision of the identified lesion

D. Bisphosphonate therapy and observation

E. Thyroidectomy

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Image by Mnahi Bin Saeedan, Ibtisam Musallam Aljohani, Ayman Omar Khushaim, Salwa Qasim Bukhari, Salahudin Tayeb Elnaas — CC BY 4.0 · Source

A 62-year-old woman with osteoporosis and a history of kidney stones presents for evaluation. Her calcium is 2.9 mmol/L (2.1-2.6 mmol/L), PTH 110 pg/mL (10-65 pg/mL), and creatinine is normal. She denies neck pain or swelling. Given the imaging, what is the MOST appropriate next step?

A. Cinacalcet administration

B. Vitamin D supplementation

C. Surgical exploration and parathyroidectomy

D. Observation with serial calcium monitoring

E. Bisphosphonate therapy

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Image by Mnahi Bin Saeedan, Ibtisam Musallam Aljohani, Ayman Omar Khushaim, Salwa Qasim Bukhari, Salahudin Tayeb Elnaas — CC BY 4.0 · Source

A 62-year-old woman with osteoporosis and a history of kidney stones presents for evaluation. Her calcium is 2.9 mmol/L (2.1-2.6 mmol/L), and PTH is 110 pg/mL (10-65 pg/mL). Imaging is shown. What is the MOST appropriate next step?

A. Bisphosphonate therapy

B. Cinacalcet administration

C. Vitamin D and calcium supplementation

D. Serial calcium and PTH monitoring

E. Referral for parathyroidectomy

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Image by Mnahi Bin Saeedan, Ibtisam Musallam Aljohani, Ayman Omar Khushaim, Salwa Qasim Bukhari, Salahudin Tayeb Elnaas — CC BY 4.0 · Source

A. Vitamin D supplementation and repeat calcium level in 3 months

B. Bisphosphonate therapy

C. Kidney stone removal

D. Surgical exploration and parathyroidectomy

E. Cinacalcet administration

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A 70-year-old man presents with a vertebral fracture after a minor fall. Reviewing risk factors for osteoporosis, which of the following is the most likely risk factor?

A. Absence of family history of osteoporosis.

B. High dietary calcium intake

C. Previous fragility fracture

D. Regular vigorous exercise

E. High BMI

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A 66-year-old man, active with a good diet, whose mother had osteoporosis at age 91, wants to check his osteoporosis risk. What risk factors prompt a bone mineral density (BMD) test?

A. Asthma

B. Rheumatoid arthritis

C. Generalized anxiety disorder

D. Type 2 Diabetes Mellitus

E. Hypertension

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osteoporosis

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