PANCE Exam Practice Questions: Quiz 855

An orthopedic surgeon asks you to help him manage an 82-year-old female who just received a hip replacement as a result of a hip fracture. The patient was watering her flowers when she tripped on the water hose and heard her hip crack as she fell to the ground. She has a history of hypothyroidism, mild CVA, and hypertension. Her mother had lost about 5 inches of height in her older years. She believes that she has lost “a few inches” in comparison to her husband. On review of systems, she admits to chronic diarrhea. Her only home medication is metoprolol. On physical examination, her blood pressure is 158/90; pulse 88 and regular; the hip is tender to palpation. Labs show normal calcium, renal function, and alkaline phosphatase. You send a TSH, celiac panel, and 25-OH vitamin D level. Which of the following medications would be most effective in preventing another fracture?
- a. Raloxifene
- b. Calcitonin-salmon nasal spray
- c. Estradiol
- d. A bisphosphonate

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