A 70-year-old woman has osteoporosis on DEXA with a femoral neck T-score of -2.8. She has no esophageal disease and creatinine clearance is 62

Question

A 70-year-old woman has osteoporosis on DEXA with a femoral neck T-score of -2.8. She has no esophageal disease and creatinine clearance is 62 mL/min. Calcium and vitamin D intake are adequate. Which of the following is the most appropriate next step in management?

Accepted Answer

Start oral alendronate

Answer

Start chronic high-dose glucocorticoids

Answer

Begin estrogen therapy as first-line therapy

Answer

Avoid pharmacotherapy until fracture occurs

Answer

Use calcitonin nasal spray as preferred treatment

Osteoporosis treatment — USMLE Step 3 MCQ

A 70-year-old woman has osteoporosis on DEXA with a femoral neck T-score of -2.8. She has no esophageal disease and creatinine clearance is 62 mL/min. Calcium and vitamin D intake are adequate. Which of the following is the most appropriate next step in management?