ROSH Geriatrics Practice Test 2025 – 400 Free Practice Questions to Pass the Exam

For a patient with chronic symptomatic hypercalcemia of malignancy, the most appropriate medication to administer is denosumab. This medication is a fully human monoclonal antibody that inhibits RANKL (receptor activator of nuclear factor kappa-β ligand), which plays a significant role in the regulation of bone metabolism. By inhibiting RANKL, denosumab effectively reduces bone resorption and helps lower elevated calcium levels associated with malignancy.

Denosumab is particularly useful in cases of hypercalcemia caused by malignancies where osteoclastic activity is contributing to the hypercalcemic state. This could be due to multiple myeloma or solid tumors that stimulate bone resorption. Its mechanism contrasts with other treatments which may not target the immediate cause of hypercalcemia as effectively.

While other options, like calcitonin and zoledronic acid, can also be used in cases of hypercalcemia, they may not provide the same rapid and sustained effect in managing malignancy-associated hypercalcemia. Cinacalcet, on the other hand, is primarily used in conditions such as secondary hyperparathyroidism and is less common in the context of malignancy-related hypercalcemia. Thus, denosumab stands out as the most