que - childdoc

[ArchivalUser]

A 26-year-old white female presents ten weeks after delivery with acute, mid-thoracic back pain. X-ray of the thoracic spine revealed a compression fracture of the T8 vertebra. Her pregnancy was complicated by extensive deep venous thrombosis (DVT), for which she was on subcutaneous heparin for the last 20 weeks of her pregnancy. Her past medical history, aside from her history of DVT, is unremarkable. Her family history is unremarkable. She has not had any menstrual periods since her delivery. She is currently breast-feeding her baby. She takes a daily supplement of 1200 mg of elemental calcium and 800 international units of vitamin D. Tenderness over the mid-thoracic spine is noted. The rest of the physical examination is unremarkable. The serum calcium, phosphorus, and 25-hydroxyvitamin D levels are normal. What is the next best step in the management of this patient?


A) Double the dose of calcium and vitamin D

B) Check serum PTH levels

C) Start on hormone replacement therapy

D) Discontinue breast-feeding

E) Start alendronate

[ArchivalUser]

I would start alendronate, E.

[ArchivalUser]

i would go with D

[ArchivalUser]

Please give reason and explain the answers as per your understanding, I will appriciate........

[ArchivalUser]

D is right ans.

Normal females can lose up to 4-6% of their bone mass during the first 4-6 months of the postpartum period, but most will regain after war.BMD can also reduced significantlyby long term heparin use.So this pt has both heparin use and breastfeeding.So D/C Breastfeeding.

[ArchivalUser]

can u pls post the rt answer..thanks.

[ArchivalUser]

ans. d
i have seen this q. before

[ArchivalUser]

D is the right ans, you guys are gr8

[ArchivalUser]

I saw this question also. I picked the same answer twice!

[ArchivalUser]

i wishe if somone can explian the concept here more.i mean what if we increase her ca intake..is she pouring her bone in the milk or what!!