Metabolic bone disease: contraindication to teriparatide: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Orthopaedics · Metabolic bone disease: contraindication to teriparatide

Sample item

Teriparatide is being considered for patients with severe osteoporosis. In which patient is it contraindicated?

AA woman with a T-score of -3.2 and prior hip fractureBA man with osteoporosis and well-controlled hypertensionCA woman with two vertebral fractures on steroidsDA man with Paget disease of bone

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. A man with Paget disease of bone

Teriparatide is avoided in patients at increased risk of osteosarcoma, including Paget disease, unexplained raised alkaline phosphatase, previous skeletal radiotherapy, open epiphyses and bone metastases. The other patients have established severe osteoporosis, which is the indication.

Option by option

A. A woman with a T-score of -3.2 and prior hip fracture
A low T-score with a previous hip fracture is also an indication.
B. A man with osteoporosis and well-controlled hypertension
Controlled hypertension is not a contraindication to teriparatide.
C. A woman with two vertebral fractures on steroids
Vertebral fractures during steroid therapy are an indication for an anabolic agent.
D. A man with Paget disease of bone (correct)
Correct. Paget disease raises osteosarcoma risk, so teriparatide is contraindicated.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is D, A man with Paget disease of bone. Teriparatide is avoided in patients at increased risk of osteosarcoma, including Paget disease, unexplained raised alkaline phosphatase, previous skeletal radiotherapy, open epiphyses and bone metastases.

Why is "A woman with a T-score of -3.2 and prior hip fracture" not the answer?

A low T-score with a previous hip fracture is also an indication.

Why is "A man with osteoporosis and well-controlled hypertension" not the answer?

Controlled hypertension is not a contraindication to teriparatide.

Why is "A woman with two vertebral fractures on steroids" not the answer?

Vertebral fractures during steroid therapy are an indication for an anabolic agent.

What concept does this question test?

It tests Metabolic bone disease: contraindication to teriparatide in Orthopaedics. The other patients have established severe osteoporosis, which is the indication.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Metabolic bone disease: contraindication to teriparatide?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.