Question:
60 year old elderly female with previous h/o Colles fracture is complaining of backache. Which of the given statements is wrong in relation to treatment of this patient?
60 year old elderly female with previous h/o Colles fracture is complaining of backache. Which of the given statements is wrong in relation to treatment of this patient?
Show Hint
Recall the correct sequence of osteoporosis pharmacotherapy -- which drug class is first-line and which is reserved for refractory cases.
Updated On: Jun 23, 2026
- Teriparatide should be started before supplementing bisphosphonates
- Bisphosphonates not given for more than a year
- Calcium requirement is 1200 mg per day
- Oral Vit D3 given along with oral calcium
Show Solution
Verified By Collegedunia
The Correct Option is A
Solution and Explanation
Step 1: Identify the clinical context. A 60-year-old postmenopausal female with a prior Colles fracture (fragility fracture of the wrist) and backache almost certainly has osteoporosis. The question asks which statement about treatment is wrong.
Step 2: Evaluate each option.
Option A (the wrong statement): Teriparatide should be started before bisphosphonates. This is INCORRECT. The correct treatment sequence is: bisphosphonates are used FIRST as first-line antiresorptive therapy for osteoporosis. Teriparatide (recombinant PTH 1-34) is an anabolic agent reserved for severe osteoporosis or when bisphosphonates fail or are contraindicated. Antiresorptive agents (bisphosphonates) are started first; teriparatide comes AFTER, not before.
Option B: Bisphosphonates not given for more than a year. Partially correct in context -- bisphosphonate holidays are recommended after 3-5 years of use to reduce risk of atypical fractures and osteonecrosis of the jaw. However, in severe osteoporosis, longer use may be warranted. The statement is an oversimplification but the question identifies Option A as the clearly wrong statement.
Option C: Calcium requirement is 1200 mg per day. CORRECT -- postmenopausal women require 1200 mg of elemental calcium per day for bone health (per NOF guidelines).
Option D: Oral Vit D3 given along with oral calcium. CORRECT -- vitamin D is always supplemented with calcium to ensure adequate calcium absorption. Vitamin D3 (cholecalciferol) is the preferred form.
Step 3: Conclusion. The WRONG statement is A -- teriparatide is not started before bisphosphonates; bisphosphonates are first-line therapy.
Step 2: Evaluate each option.
Option A (the wrong statement): Teriparatide should be started before bisphosphonates. This is INCORRECT. The correct treatment sequence is: bisphosphonates are used FIRST as first-line antiresorptive therapy for osteoporosis. Teriparatide (recombinant PTH 1-34) is an anabolic agent reserved for severe osteoporosis or when bisphosphonates fail or are contraindicated. Antiresorptive agents (bisphosphonates) are started first; teriparatide comes AFTER, not before.
Option B: Bisphosphonates not given for more than a year. Partially correct in context -- bisphosphonate holidays are recommended after 3-5 years of use to reduce risk of atypical fractures and osteonecrosis of the jaw. However, in severe osteoporosis, longer use may be warranted. The statement is an oversimplification but the question identifies Option A as the clearly wrong statement.
Option C: Calcium requirement is 1200 mg per day. CORRECT -- postmenopausal women require 1200 mg of elemental calcium per day for bone health (per NOF guidelines).
Option D: Oral Vit D3 given along with oral calcium. CORRECT -- vitamin D is always supplemented with calcium to ensure adequate calcium absorption. Vitamin D3 (cholecalciferol) is the preferred form.
Step 3: Conclusion. The WRONG statement is A -- teriparatide is not started before bisphosphonates; bisphosphonates are first-line therapy.
Was this answer helpful?
0
0
Top NEET PG Orthopedics Questions
- A child was brought with bony deformities, as shown in the radiograph below. It could be due to the deficiency of which of the following?
- In which of the following nerve injuries is the instrument shown below used?
- A patient presented with chronic knee pain but has no history of trauma. Identify the condition shown in the radiograph below and the appropriate management.
- A patient at the orthopedics OPD complains of troubled sleep at night due to numbness andtingling sensation involving his lateral 3 digits. His symptoms are relieved as he lays his armshanging from the bed. Which of the following options correctly describes his condition and thetest used to assess it?
- A child is brought to the orthopedics OPD with a deformity in the lower limb and hyperpigmented skin lesions. The x-ray of her thigh is shown below. What is the most likely diagnosis?
View More Questions
Top NEET PG Osteoporosis Questions
Top NEET PG Questions
- A patient hailing from Delhi presents with fever, arthralgia, and extensive petechial rash for 3 days. Lab investigations revealed a hemoglobin of 9 g/ dL, a white blood cell count of 9000 cells/mm3, a platelet count of 20000 cells/mm3, and a prolonged bleeding time. The clotting time was normal. What is the most likely diagnosis?
- Which of the following statements is true about Trichomonas vaginalis?
- A lady from West Rajasthan presented with an ulcer surrounded by erythema on the right leg. Microscopy of the biopsy from the edge of the ulcer showed organisms with dark staining nuclei and kinetoplast. What is the most likely causative agent?
- A child presents with a fever and a rash. Urine examination showed cells with owl's eye appearance. What is the most likely diagnosis?
- Infection with Clonorchis sinensis is associated with an increased risk of__?
View More Questions