Metabolic bone: denosumab: 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: denosumab

Sample item

A patient stops denosumab after 3 years of treatment for osteoporosis. What is the recognised risk?

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

The answer and the reasoning

A. Rebound bone loss with multiple vertebral fractures

Denosumab is a monoclonal antibody against RANKL that suppresses osteoclasts. When stopped, there is a rebound surge in bone turnover with rapid loss of density and an increased risk of multiple vertebral fractures, so a bisphosphonate is typically given afterwards.

Option by option

  • A. Rebound bone loss with multiple vertebral fractures (correct)

    Correct. Rebound fractures can occur after stopping denosumab.

  • B. Immediate fracture healing

    Stopping does not accelerate healing.

  • C. No change in bone turnover

    Turnover rises sharply after cessation.

  • D. Hypercalcaemia only

    Hypercalcaemia may occur but the key hazard is fractures.

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 A, Rebound bone loss with multiple vertebral fractures. Denosumab is a monoclonal antibody against RANKL that suppresses osteoclasts.

Why is "Immediate fracture healing" not the answer?

Stopping does not accelerate healing.

Why is "No change in bone turnover" not the answer?

Turnover rises sharply after cessation.

Why is "Hypercalcaemia only" not the answer?

Hypercalcaemia may occur but the key hazard is fractures.

What concept does this question test?

It tests Metabolic bone: denosumab in Orthopaedics. When stopped, there is a rebound surge in bone turnover with rapid loss of density and an increased risk of multiple vertebral fractures, so a bisphosphonate is typically given afterwards.

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: denosumab?

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.