Paget ALP Monitoring — SCE Rheumatology MCQ
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Correct answer: D — ALP is the primary parameter reflecting disease activity and treatment response; should fall significantly within 3-6 months
The best answer is “ALP is the primary parameter reflecting disease activity and treatment response; should fall significantly within 3-6 months”. ALP is the primary parameter reflecting disease activity and treatment response; should fall significantly within 3-6 months is supported by the cited UK or directly applicable specialist authority and best matches the tested threshold, complication or monitoring principle. The remaining choices—“ESR, within a rheumatology pathway, with clinical reassessment, within a rheumatology pathway, after safety review, after specialist assessment”, “CRP, after safety review, within a rheumatology pathway, after safety review, after specialist assessment, with clinical reassessment”, “Annual bone scan, after specialist assessment, after safety review, after specialist assessment, with clinical reassessment, within a rheumatology pathway”, “Calcium, with clinical reassessment, after specialist assessment, with clinical reassessment, within a rheumatology pathway, after safety review”—are credible in related rheumatology presentations, but each addresses a different diagnosis, investigation, treatment sequence or complication and does not fit the decisive findings in this stem.
Reference: Paget’s Association clinical guideline: https://pmc.ncbi.nlm.nih.gov/articles/PMC6522384/