DEXA DEXA Pharmacology & Osteoporosis Treatment Monitoring 2

Question 1

A patient taking long-term glucocorticoids (prednisone ≥5 mg/day for ≥3 months) presents for a DEXA scan. Why is this clinically important?

Accepted Answer

Glucocorticoids cause glucocorticoid-induced osteoporosis (GIO), a major secondary cause of bone loss

Answer

Glucocorticoid-induced osteoporosis is the most common secondary cause of osteoporosis, and baseline and monitoring DEXA scans are recommended for these patients.

Question 2

Which FRAX input variable directly represents the skeletal impact of chronic glucocorticoid use?

Accepted Answer

Secondary osteoporosis checkbox and glucocorticoid input field

Answer

FRAX includes a secondary osteoporosis field and a separate glucocorticoid input that adjusts fracture probability upward for chronic steroid users.

Question 3

What is the recommended DEXA monitoring interval for patients on long-term glucocorticoid therapy?

Accepted Answer

Every 1–2 years for patients on ongoing glucocorticoid therapy

Answer

ACR and ISCD recommend monitoring DEXA every 1–2 years in patients on ongoing glucocorticoid therapy due to the risk of rapid bone loss.

Question 4

A DEXA report shows a patient's hip BMD increased by 3% after 2 years of denosumab therapy, but the result is below the LSC. How should this be interpreted?

Accepted Answer

The change is not statistically significant and may be within measurement error

Answer

A BMD change below the LSC cannot be distinguished from measurement variability and should not be used alone to make treatment decisions.

Question 5

Which lab values are most important to review before initiating bisphosphonate therapy in a patient with low bone density?

Accepted Answer

Serum creatinine/eGFR (renal function) and 25-hydroxyvitamin D

Answer

Bisphosphonates are contraindicated in severe renal impairment (eGFR <30–35), and vitamin D deficiency must be corrected before therapy to avoid hypocalcemia.

(DEXA) DEXA Bone Density Scan Certification Practice Test

(DEXA) DEXA Bone Density Scan Certification Practice Test

DEXA DEXA Pharmacology & Osteoporosis Treatment Monitoring 2