skip to main content

Paget's disease of bone — SCE Endocrinology MCQ

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

ModerateCalcium/BonePaget's disease of boneSCE Endocrinology

A 66-year-old man has skull enlargement, hearing loss and raised alkaline phosphatase. Calcium, phosphate and PTH are normal. Bone scan shows increased uptake in the skull and pelvis. What is the most appropriate management?

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

Reveal the answer and explanation

Correct answer: B — Treat symptomatic disease with intravenous zoledronic acid

Treat symptomatic disease with intravenous zoledronic acid is best because symptomatic active Paget's disease is treated with a potent bisphosphonate such as zoledronic acid. The alternatives are less appropriate because cinacalcet treats hyperparathyroidism; normal calcium does not make Paget's benign; calcium does not suppress pagetic turnover; glucocorticoids are not standard therapy. The SCE teaching point is to integrate the clinical pattern, biochemistry and context rather than treating an isolated result.

Reference: Paget's Association/NICE CKS Paget disease