CLINICAL CASE #3

Juan Ramón Chaparro Gasca

10 de septiembre de 2023

Licenciatura: Médico Cirujano

Octavo semestre
Ingles de la Práctica Clínica
Docente titular: Ávila González Ana Catalina del Pilar

Notas del Autor.

Facultad de Ciencias de Medicina, Universidad del Valle de México
La correspondencia relacionada con esta investigación debe ser dirigida a Juan
Ramón Chaparro Gasca, Universidad del Valle de México, Naranjos Punta
Juriquilla 1000 Santa Rosa Jáuregui, 76230 Santiago de Querétaro, Qro.

Contacto:
Juan Ramón Chaparro Gasca
Correo: A110173032@my.uvm.edu.mx
Clinical case
A 73-year-old asymptomatic white woman with a history of a Colles fracture of the
left radius 10 years earlier presents for evaluation. Dual-energy x-ray bsorptiometry
reveals a bone mineral density (BMD) T score of −2.8 in the lumbar spine and −2.5
in the total hip.

Patient
73 years old female, white, no allergies registered.
Subjective
She was asymptomatic, with background of a Colles fracture of the left radius 10
years earlier, presents for evaluation with osteoporosis test results.
Objective
Alerted, oriented, cooperative, well hydrated, normal cardiovascular examination,
normal respiratory examination. Studies results: Dual-energy x-ray bsorptiometry
reveals a bone mineral density (BMD) T score of −2.8 in the lumbar spine and −2.5
in the total hip.
Analysis
Female in her 7th decade diagnosed with osteoporosis.
Plan
Nonpharmacologic

• Resistance and weight-bearing exercise

• Calcium 1200 mg per day
• Vitamin D 800–1000 IU per day
• Avoidance of smoking and excess alcohol intake
Pharmacologic Therapies

• Antiresorptive
o Alendronate oral 30-70 mg/ wk
o Risedronate oral 25mg/wk or 150mg/ mo (in a single dose or two
doses of 75mg on consecutive days)
o Ibandronate oral 150mg/ wk or 3mg every 3 months
o Zoledronic acid intravenous 5mg/ year
• Anabolic
o Teriparatide subcutaneous 20ug/ day
 • Biologic
o Denosumab subcutaneous 60mg every 6 months
• Estrogens
o Conjugated equine estrogen oral 0.15-1.25 mg/day
o 17B- estradiol oral 0.025-0.10 mg/day
o Ultra low dose 17B- estradiol oral 0.014 mg/ day

References:
Solomon, Caren G.; Black, Dennis M.; Rosen, Clifford J. (2016). Postmenopausal
Osteoporosis. New England Journal of Medicine, 374(3), 254–262.
doi:10.1056/NEJMcp1513724
Menopausia y la mujer madura. Hoffman B.L., & Schorge J.O., & Halvorson L.M., &
Hamid C.A., & Corton M.M., & Schaffer J.I.(Eds.), (2020). Williams Ginecología, 4e.
McGraw Hill.
https://accessmedicina.mhmedical.com/content.aspx?bookid=2974&sectionid=250
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