A 65 year old Asian female presents for her Medicare physical and osteoporosis screening. She went through menopause at age 51. Nonsmoker. Occasional glass of wine. FH: her mother and maternal grandmother had osteoporosis. You order a DEXA scan with these results: Spine normal Femur T-Score: -2.0 FRAX scores: Hip fracture: 2.0% Major osteoporotic fracture: 12.0% CRITERIA: Normal: T-score at or above -1 SD Osteopenia: T-score between -1 and -2.5 SD Osteoporosis: T-score at or below -2.5 SD FRAX score: 10 year probability of hip fracture >3% or major osteoporotic fracture >20% What is your next course of action? Group of answer choices Prescribe Prolia 60 mg SC every 6 months and repeat DEXA in one year Prescribe Reclast 5 mg IV x one dose for prevention and repeat DEXA in 2 years Discuss modifiable risk factors and repeat DEXA in 2 years Prescribe a oral bisphosphonate and repeat DEXA in 2 years
