Primary Care i-Newsletter: Osteoporosis Edition
Before the Break: Identifying and Treating Patients At Risk for Osteoporosis

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Please refer to this case to answer questions 1 and 2:

AB is a 73-year-old woman who presents to clinic for her annual physical. She had a recent bone density measurement (BMD) with a T-score of -2.6 at the hip; her BMI is 28; she has had no previous fractures, although her mother had a hip fracture at the age of 80 years. She states that she smokes one pack of cigarettes per day, and drinks approximately one glass of wine each night.
For AB, which of the following would be considered risk factors for future fractures? Select all that apply.
Based on the FRAX algorithm, AB’s 10-year probability of a major osteoporotic fracture is 32%. How likely are you to:
Very likely
6
5
4
3
2		Not likely at all
1
Advise her to lose weight
Advise her to quit smoking
Start her on HRT
Start her on oral bisphosphonates
Start her on IV bisphosphonates
Start her on a RANKL inhibitor
Based on the pivotal clinical trials (HORIZON, BONE, MORE, FREEDOM), which of the following osteoporotic medications reported the greatest reduction in vertebral fracture?
It is better to take calcium and vitamin D supplements versus getting them through dietary intake.

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