American Board of Internal Medicine (ABIM) Certification Practice Exam

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Which of the following is NOT a side effect of bisphosphonates?

Kidney injury
Fever
Hypoglycemia
Osteonecrosis of the jaw

The correct answer is: Hypoglycemia

Hypoglycemia is not a recognized side effect of bisphosphonates. Bisphosphonates are primarily used in the treatment of osteoporosis and other conditions that involve bone resorption, and their side effects typically relate to renal function, inflammatory responses, and specific complications associated with bone health. The other options represent well-documented potential side effects of bisphosphonates. Kidney injury can arise due to the drug's effects on renal function, especially in patients who may be at risk or have underlying kidney disease. Fever can occur as part of an acute infusion reaction or due to the inflammatory activity that bisphosphonates can induce in some patients. Osteonecrosis of the jaw is a serious condition associated with bisphosphonate therapy, particularly in patients undergoing cancer treatment or those with other risk factors, leading to a significant complication involving bone tissue in the jaw. Overall, while bisphosphonates have various side effects that can affect kidney function, cause fever, and potentially lead to osteonecrosis of the jaw, hypoglycemia is not among the adverse effects attributable to this class of medications.