Endocrine drugs: zoledronic acid acute-phase reaction: practice question

A Pharmacology 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.

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Pharmacology · Endocrine drugs: zoledronic acid acute-phase reaction

Sample item

A 66-year-old woman receives her first intravenous zoledronic acid infusion for osteoporosis. Twenty-four hours later she has fever, myalgia and malaise that resolve in three days. What is the best advice?

AStart intravenous antibiotics for presumed bacterial sepsisBReassure and give paracetamol: a usual first-dose reactionCGive calcitriol to correct presumed hypocalcaemiaDTreat as an anaphylactic reaction and avoid all bisphosphonates

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

The answer and the reasoning

B. Reassure and give paracetamol: a usual first-dose reaction

An acute-phase reaction with fever, myalgia and flu-like symptoms follows the first infusion in many patients and is self-limiting, probably through cytokine release. It rarely recurs with later doses, and paracetamol helps.

Option by option

A. Start intravenous antibiotics for presumed bacterial sepsis
There is no sign of sepsis, and the timing and course fit a drug reaction.
B. Reassure and give paracetamol: a usual first-dose reaction (correct)
Correct. This is a benign acute-phase reaction treated with simple analgesics.
C. Give calcitriol to correct presumed hypocalcaemia
Hypocalcaemia causes tingling and cramps, not fever, and calcitriol does not treat the reaction.
D. Treat as an anaphylactic reaction and avoid all bisphosphonates
Anaphylaxis presents within minutes with wheeze, urticaria and hypotension, not a delayed flu-like illness.

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 Pharmacology question

What is the answer to this Pharmacology question?

The best answer is B, Reassure and give paracetamol: a usual first-dose reaction. An acute-phase reaction with fever, myalgia and flu-like symptoms follows the first infusion in many patients and is self-limiting, probably through cytokine release.

Why is "Start intravenous antibiotics for presumed bacterial sepsis" not the answer?

There is no sign of sepsis, and the timing and course fit a drug reaction.

Why is "Give calcitriol to correct presumed hypocalcaemia" not the answer?

Hypocalcaemia causes tingling and cramps, not fever, and calcitriol does not treat the reaction.

Why is "Treat as an anaphylactic reaction and avoid all bisphosphonates" not the answer?

Anaphylaxis presents within minutes with wheeze, urticaria and hypotension, not a delayed flu-like illness.

What concept does this question test?

It tests Endocrine drugs: zoledronic acid acute-phase reaction in Pharmacology. It rarely recurs with later doses, and paracetamol helps.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Endocrine drugs: zoledronic acid acute-phase reaction?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology 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.