A 74 year old Caucasian female had a bone density study(DXA) which revealed T-score of the right femoral neck of -2.8, left femoral neck of -2.9. The spine had degenerative changes and could not be interpreted. FRAX calculation revealed fracture risk of 10% ten year risk of hip fracture and 30% ten year risk of major osteoporotic fracture. She had a traumatic wrist fracture a few years ago. Family history is positive for a mother with a hip fracture. Management of this patient would best include:

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Question 1 of 5

A 74 year old Caucasian female had a bone density study(DXA) which revealed T-score of the right femoral neck of -2.8, left femoral neck of -2.9. The spine had degenerative changes and could not be interpreted. FRAX calculation revealed fracture risk of 10% ten year risk of hip fracture and 30% ten year risk of major osteoporotic fracture. She had a traumatic wrist fracture a few years ago. Family history is positive for a mother with a hip fracture. Management of this patient would best include:

Correct Answer: D

Rationale: Treatment is recommended for patients with high FRAX scores and low T-scores. Repleting vitamin D and starting anti-resorptive or anabolic agents are effective treatments.

Question 2 of 5

A 40-year-old male presents with fever, chills, and a new heart murmur. Blood cultures grow Streptococcus viridans. What is the most likely diagnosis?

Correct Answer: A

Rationale: The presence of fever, a new heart murmur, and positive blood cultures for Streptococcus viridans strongly suggest infective endocarditis.

Question 3 of 5

66 yo woman presents to the emergency room with 3 hours of right-sided face and arm numbness and weakness. In the ER, her examination confirms both a sensory and motor deficit involving the right face and arm.

Correct Answer: D

Rationale: tPA is the first-line treatment for acute ischemic stroke within the appropriate time window.

Question 4 of 5

All are false in lymphoma except:

Correct Answer: C

Rationale: Reed-Sternberg cells define Hodgkin lymphoma. FNA is inadequate (A), B symptoms worsen prognosis (B), and combined therapy increases malignancy risk (D).

Question 5 of 5

Which of the following is a common clinical feature of community-acquired pneumonia?

Correct Answer: D

Rationale: Cough, fever, and pleuritic chest pain are all common clinical features of community-acquired pneumonia, making 'All of the above' the correct answer.

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