skip to main content

Glucocorticoid-induced osteoporosis — SCE Rheumatology MCQ

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

ModerateRheumatological pharmacologyGlucocorticoid-induced osteoporosisSCE Rheumatology

A 42-year-old woman has inflammatory musculoskeletal symptoms evolving over several weeks with features suggestive of glucocorticoid-induced osteoporosis. Examination shows there is objective synovitis or organ involvement on examination. Investigations show targeted investigations support an immune-mediated rheumatological disorder. The diagnosis is established and symptoms remain clinically important despite initial supportive measures. There is no contraindication to disease-modifying or anti-inflammatory escalation. What is the most appropriate management?

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

Reveal the answer and explanation

Correct answer: C — Prescribe bone protection

Prescribe bone protection is the best answer because prescribe bone protection is the most appropriate next step for glucocorticoid-induced osteoporosis in this clinical setting. Check full blood count and liver tests is a plausible distractor, but it does not account for the key discriminator in the stem. Mycophenolate mofetil and Oral prednisolone would be more appropriate in a different clinical pattern or at another point in the pathway, while Therapeutic exercise is suboptimal for this presentation. Clinical pearl: rheumatology management is generally treat-to-target, but infection risk, pregnancy plans and shared-care monitoring often determine the safest answer.

Reference: BSR csDMARD monitoring guideline; BSR biologic/targeted DMARD safety guideline; BNF