Long-term glucocorticoid therapy — SCE Rheumatology MCQ

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HardRheumatological pharmacologyLong-term glucocorticoid therapySCE Rheumatology

A 70-year-old woman with vasculitis has received prednisolone for 9 months. Examination shows proximal weakness and bruising are present. Investigations show DEXA shows declining hip bone density. What is the most important complication to screen for?

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Correct answer: B — Fragility fracture and steroid-induced osteoporosis

The best answer is “Fragility fracture and steroid-induced osteoporosis”. Fragility fracture and steroid-induced osteoporosis is supported by the cited UK or directly applicable specialist authority and best matches the tested threshold, complication or monitoring principle. The remaining choices—“Uveitis, after specialist assessment”, “Renal crisis, with clinical reassessment”, “Tophaceous gout, within a rheumatology pathway”, “Lymphoma, 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: NICE NG226 osteoarthritis: https://www.nice.org.uk/guidance/ng226/chapter/Recommendations