Step 3 UWSA Practice Exam

In postmenopausal osteoporosis, reducing osteoclast-driven bone loss lowers the risk of vertebral fractures. Bisphosphonates are potent antiresorptives that bind to bone and inhibit osteoclast activity, leading to decreased bone turnover and increased bone density. This direct suppression of bone resorption translates into a proven reduction in vertebral fracture risk, making them the preferred therapy for someone with a vertebral compression fracture. Other options have weaker or more context-specific effects: calcitonin has a less robust impact on fracture risk, hormone replacement therapy lowers fracture risk but carries significant risks (like thromboembolism and hormone-sensitive cancers), and thiazide diuretics may modestly influence calcium handling but do not address osteoporosis as effectively as bisphosphonates.