A 74-year-old woman with eGFR 42 ml/min/1.73 m2 sustains a fragility hip fracture. DXA later shows femoral neck T-score -2.9 and corrected calcium is

Question

A 74-year-old woman with eGFR 42 ml/min/1.73 m2 sustains a fragility hip fracture. DXA later shows femoral neck T-score -2.9 and corrected calcium is normal. She has oesophagitis and cannot tolerate oral bisphosphonates. What is the most appropriate management?

Accepted Answer

Offer intravenous zoledronic acid after dental and renal assessment

Answer

Start high-dose vitamin D as fracture treatment

Answer

Use calcitonin nasal spray as first-line long-term therapy

Answer

Start raloxifene as preferred treatment after hip fracture

Answer

Avoid antiresorptive therapy because oral treatment is unsuitable

Postmenopausal osteoporosis — SCE Endocrinology MCQ

A 74-year-old woman with eGFR 42 ml/min/1.73 m2 sustains a fragility hip fracture. DXA later shows femoral neck T-score -2.9 and corrected calcium is normal. She has oesophagitis and cannot tolerate oral bisphosphonates. What is the most appropriate management?