Metabolic bone: bisphosphonates: 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.

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Orthopaedics · Metabolic bone: bisphosphonates

Sample item

A rare complication of long-term bisphosphonate therapy is what?

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

The answer and the reasoning

C. Atypical subtrochanteric femoral fracture

Bisphosphonates inhibit osteoclasts by blocking farnesyl pyrophosphate synthase, and prolonged use may cause oversuppressed turnover, atypical femoral fractures and osteonecrosis of the jaw. They should be taken upright with water on an empty stomach to avoid oesophagitis.

Option by option

  • A. Osteopetrosis

    Osteopetrosis is a genetic disease, although overtreatment can mimic dense bone.

  • B. Rickets

    Rickets is not caused by bisphosphonates.

  • C. Atypical subtrochanteric femoral fracture (correct)

    Correct. Atypical femoral fractures are a known rare complication.

  • D. Hypercalcaemia

    Bisphosphonates lower, not raise, serum calcium.

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.

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Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is C, Atypical subtrochanteric femoral fracture. Bisphosphonates inhibit osteoclasts by blocking farnesyl pyrophosphate synthase, and prolonged use may cause oversuppressed turnover, atypical femoral fractures and osteonecrosis of the jaw.

Why is "Osteopetrosis" not the answer?

Osteopetrosis is a genetic disease, although overtreatment can mimic dense bone.

Why is "Rickets" not the answer?

Rickets is not caused by bisphosphonates.

Why is "Hypercalcaemia" not the answer?

Bisphosphonates lower, not raise, serum calcium.

What concept does this question test?

It tests Metabolic bone: bisphosphonates in Orthopaedics. They should be taken upright with water on an empty stomach to avoid oesophagitis.

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 Metabolic bone: bisphosphonates?

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.