Question 1

A patient has bone pain and laboratory testing reveals an elevated serum alkaline phosphatase (SAP). Which test can help distinguish Paget's from malignant bone disease?&#10;A) Bone densitometry&#10;B) Bone marrow biopsy&#10;C) Bone radiograph&#10;D) Bone scan

Accepted Answer

Bone radiograph can show characteristic changes in bone structure associated with Paget's disease, such as thickened and deformed bones, which helps distinguish it from malignant bone disease.

Question 2

The primary care provider is assessing a 45-year-old postmenopausal woman who has a family history of osteoporosis. Which test will be most useful to screen for this disease in this patient?&#10;A) Biochemical markers of bone resorption and bone formation&#10;B) Bone densitometry of the hip and posteroanterior lumbar spine&#10;C) Plain radiographs of the hips and lumbar and thoracic spine&#10;D) Serum calcium and serum 25-hydroxyvitamin D

Accepted Answer

The most useful test to screen for osteoporosis in a postmenopausal woman with a family history of the disease is bone densitometry (usually by dual energy x-ray absorptiometry or DXA) of the hip and posteroanterior lumbar spine. This test measures bone mineral density and assesses the risk of fractures. Biochemical markers of bone resorption and bone formation may be used to monitor the disease but are not typically used for initial screening. Plain radiographs are not as sensitive as bone densitometry in detecting osteoporosis. Serum calcium and serum 25-hydroxyvitamin D may be assessed to rule out other possible causes of bone loss, but they are also not specific for osteoporosis.

Question 3

A patient is diagnosed with osteoporosis. What is the recommended treatment once the diagnosis is made?&#10;A) Bisphosphonate therapy&#10;B) Calcium and vitamin D&#10;C) Estrogen replacement&#10;D) Yoga and weight-bearing exercises

Accepted Answer

Bisphosphonate therapy is the first-line treatment for osteoporosis as it helps to prevent bone loss and reduce the risk of fractures.

Deck 163: Metabolic Bone Disease: Osteoporosis and Pagets Disease of the Bone