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Osteoporosis — SCE Rheumatology MCQ

Instant feedback + full explanation. One question, done properly.

HardMetabolic bone diseaseOsteoporosisSCE Rheumatology

A high-risk patient must stop denosumab after 5 years because of an unavoidable contraindication. Renal function permits bisphosphonate use. What sequence best limits rebound vertebral-fracture risk?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Give zoledronate at 6 months and use CTX thereafter

Explanation lettering: C = shown as B · D = shown as C · B = shown as D

E is correct. NOGG recommends IV zoledronate 6 months after the final denosumab injection, with serum CTX guiding further treatment; if CTX is unavailable, a second zoledronate infusion 6 months later can be considered. Observation permits rebound bone turnover, and teriparatide alone may worsen early bone loss. An 18-month delay or DXA-only strategy misses the high-risk interval.

Reference: NOGG pharmacological treatment recommendations. https://www.nogg.org.uk/full-guideline/section-6-pharmacological-treatment-options