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USMLE · Question #478
USMLE Question #478: Real Exam Question with Answer & Explanation
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Question
A 62-year-old woman comes to the physician because of low back pain for 1 week. Menopause occurred 10 years ago. Physical examination shows localized tenderness over the lumbar spine after movement. X-rays of the spine show a compression fracture of L1-2. A DEXA scan shows decreased bone mineral density. Serum calcium and phosphorus concentrations and serum alkaline phosphatase activity are within the reference ranges. A bisphosphonate drug is prescribed. The expected beneficial effect of this drug is most likely due to which of the following actions?
Options
- ADecreased insulin-like growth factor-1 concentration
- BDecreased osteoclast activity
- CDecreased osteoprotegerin production
- DIncreased 1, 25- dihydroxycholecalciferol concentration
- EIncreased osteoblast actitvity
- FIncreased receptor activator of NF-kB ligand (RANKL) production
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