Osteoporosis (2) (Msq Drill 159)
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- 1.
Up to 1 standard deviation drop in bone mineral density the fracture risk increases by:
- A.
1%
- B.
1.5%
- C.
2.5%
- D.
2.6%
Correct Answer
D. 2.6% -
- 2.
What about fracture risk with 2.5 standard deviation in bone mineral density. What is the fracture risk?
- A.
3%
- B.
3.5%
- C.
4%
- D.
10%
Correct Answer
D. 10% -
- 3.
In other words the increased risk of fractures as we move further away from the mean is NOT linear. True or false?
- A.
True
- B.
False
Correct Answer
A. True -
- 4.
What is the most common nonvertebral fracture in white women until the age of 75?
- A.
Proximal fibula
- B.
Distal radius
- C.
Proximal ulna
- D.
Proximal femur
- E.
Hip
Correct Answer
B. Distal radius -
- 5.
When patients with osteoporosis have a spinal fracture it is usually:
- A.
Painless
- B.
From compressive loading
- C.
Fom deceleration acceleration
Correct Answer(s)
A. Painless
B. From compressive loading -
- 6.
Which of the following are potential utilities for bone density measurement?
- A.
Helps to assess future fracture risk
- B.
Helps to confirm diagnosis of osteoporosis
- C.
Helps to monitor effects of treatment
- D.
Helps to assess rate of bone loss
- E.
Helps to enhance the patient's acceptance of and compliance with treatment
Correct Answer(s)
A. Helps to assess future fracture risk
B. Helps to confirm diagnosis of osteoporosis
C. Helps to monitor effects of treatment
D. Helps to assess rate of bone loss
E. Helps to enhance the patient's acceptance of and compliance with treatment -
- 7.
*** The WHO criteris for a diagnosis of osteoporosis is:
- A.
a T score -1.0 to -2.5 SD
- B.
< or equal to -2.5 SD (with fragility fractures)
- C.
< or equal to -2.5 SD
- D.
> or equal to -1.0 SD
Correct Answer
C. < or equal to -2.5 SD -
- 8.
Can you use calcium and vitamin D in the treatment regimen of osteoporosis?
- A.
Yes
- B.
No
Correct Answer
A. Yes -
- 9.
Which of the following are also used to treat osteoporosis?
- A.
Exercise
- B.
Bisphophonates
- C.
Calcitonin
- D.
PTH
- E.
Estrogen
Correct Answer(s)
A. Exercise
B. BispHopHonates
C. Calcitonin
D. PTH
E. Estrogen -
- 10.
Osteoporosis by itself it very painful. True or false?
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
by itself osteoporosis is painless.Rate this question:
-
- 11.
Which of the following can be done to prevent or treat osteoporosis?
- A.
Counsel all patients on risk reduction
- B.
Instruct all patients on adequate daily intake of calcium and vitamin D
- C.
Provide guidelines for regular participation in weight bearing and muscle strengthening exercises to reduce the risk of falls and fractures
- D.
Provide strategies for fall prevention
- E.
Counsel all patients on avoiding tobacco smoking and excessive alcohol intake.
Correct Answer(s)
A. Counsel all patients on risk reduction
B. Instruct all patients on adequate daily intake of calcium and vitamin D
C. Provide guidelines for regular participation in weight bearing and muscle strengthening exercises to reduce the risk of falls and fractures
D. Provide strategies for fall prevention
E. Counsel all patients on avoiding tobacco smoking and excessive alcohol intake. -
- 12.
Patients with a calcium deficiency should supplement their calcium in order to meet the recommeded daily intake. True or false?
- A.
True
- B.
False
Correct Answer
A. True -
- 13.
Menopausal women should take about how much calcium per day?
- A.
1200mg
- B.
1500mg
- C.
1000mg
Correct Answer
A. 1200mg -
- 14.
Women and men over the age of 65 should take how much calcium?
- A.
1200mg
- B.
1000mg
- C.
1500mg
Correct Answer
C. 1500mg -
- 15.
Do most people meet the daily requirements of Vitamin D intake?
- A.
Yes
- B.
No
Correct Answer
B. No -
- 16.
The NIH guidelines for vitamin D state that patients above the age of 70 should take how much vitamin D?
- A.
400IU
- B.
600IU
- C.
800IU
- D.
1000IU
Correct Answer
B. 600IUExplanation
Patients uder 70 should take 400IU.Rate this question:
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- 17.
Can weight bearing exercise such as walking reduce fractures?
- A.
Yes
- B.
No
Correct Answer
A. Yes -
- 18.
In which of the following will you initiate pharmacologic therapy according to NOF recommendations?
- A.
BMD T-score below -2.0 by DXA with no risk factors
- B.
BMD T-score below -1.5 by DXA with one or more risk factors
- C.
History of a prior fracture of hip fracture
- D.
BMD T-score below - with 3 or more risk factors
Correct Answer(s)
A. BMD T-score below -2.0 by DXA with no risk factors
B. BMD T-score below -1.5 by DXA with one or more risk factors
C. History of a prior fracture of hip fracture -
- 19.
Medications that are used to treat osteoporosis either work on osteoclasts or osteoblasts. which of the following two classes of medications works on osteoclastic activity?
- A.
Antiresorptive
- B.
Anabolics
Correct Answer
A. Antiresorptive -
- 20.
Which of the two classes of medications used to treat osteoporosis works on bone forming actitivy?
- A.
Antiresorptives
- B.
Anabolics
Correct Answer
B. Anabolics -
- 21.
Which of the following medications that are all used in the treatment of osteoporosis is an anabolic or bone forming medication?
- A.
Bisphosphonates (alendronate, ridendronate and ibandronate)
- B.
Calcitonin
- C.
Parathyroid hormone therapy (PTH 1-34, teriparatide)
- D.
Estrogen /hormone therapy
- E.
Raloxifene
Correct Answer
C. Parathyroid hormone therapy (PTH 1-34, teriparatide)Explanation
The rest of the medications are antiresorptives or bone retaining medications.Rate this question:
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- 22.
Bisphosphonates are classified as anabolic medications. True or false?
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
Bisphosphonates are antiresorptive or bone retaining medications.Rate this question:
-
- 23.
Bisphosphonates bind to hydroxyapatite crystals in the bone and _________ bone interface.
- A.
Osteoblast
- B.
Osteoclast
Correct Answer
B. OsteoclastExplanation
This is how they prevent the osteoclasts from resorbing bone.Rate this question:
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- 24.
So, do bisphophonates lead to an increase in bone mineral density and reduced fracture rates?
- A.
Yes
- B.
No
Correct Answer
A. Yes -
- 25.
At what T-score should you use bisphophonates?
- A.
Below 1.0 from SD
- B.
Below 1.5 from SD
- C.
Below 2.0 from SD
- D.
Below 2.5 from SD
Correct Answer
C. Below 2.0 from SD -
- 26.
When administering bisphosphonates what should you tell your patients?
- A.
To take it in the evening
- B.
To take it in the morning
- C.
To takes it 30 minutes before taking anything by mouth
- D.
To take it either standing up or sitting upright in bed
- E.
To take it with 8ounces of plain water (no juice, no other medications.)
Correct Answer(s)
A. To take it in the evening
B. To take it in the morning
C. To takes it 30 minutes before taking anything by mouth
D. To take it either standing up or sitting upright in bed
E. To take it with 8ounces of plain water (no juice, no other medications.) -
- 27.
Can you prescribe both bisphosphonates and cacium/vitamin D?
- A.
Yes
- B.
No
Correct Answer
A. Yes -
- 28.
Boniva is a _______ bisphosphonate.
- A.
Daily
- B.
Weekly
- C.
Monthly
Correct Answer
C. MonthlyExplanation
there is now a q3monthly IV option now available. Results are comparable (50%) rductionin vertebral fractures in those with and without fracture history.Rate this question:
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- 29.
Is calcitonin an antiresorptive or anabolic medication?
- A.
Antiresorptive
- B.
Anabolic
Correct Answer
A. Antiresorptive -
- 30.
Calcitonin is prescribed to women who cannot tolerate other osteoporosis medications. Nevertheless these women should be at least how many years post menopausal?
- A.
1
- B.
2
- C.
3
- D.
4
- E.
5
Correct Answer
E. 5 -
- 31.
Calcitonin has been shown to decrease the risk of what types of fractures only?
- A.
Vertebral
- B.
Nonvertebral
Correct Answer
A. VertebralExplanation
There is no data on prevention of other types of fractures.Rate this question:
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- 32.
Calcitonin is administered either nasal spray or injectable. True or false?
- A.
True
- B.
False
Correct Answer
A. True -
- 33.
Calcitonin has been shown to decrease pain associated with vertebral fractures. True or false?
- A.
True
- B.
False
Correct Answer
A. True -
- 34.
Calcitonin is also an effective monotherapy for future fracture reduction. True or false?
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
It is not very effective as monotherapy for future fracture reduction.Rate this question:
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- 35.
Which of the following are adverse effects of injected calcitonin?
- A.
Backache
- B.
Headaches
- C.
Nausea/vomiting
- D.
Allergic response
Correct Answer(s)
A. Backache
B. Headaches
C. Nausea/vomiting
D. Allergic response -
- 36.
Which of the following are adverse reactions of nasal calcitonin?
- A.
Nasal irritation
- B.
Runny nose
- C.
Bloody nose
- D.
Backache
- E.
Headaches
Correct Answer(s)
A. Nasal irritation
B. Runny nose
C. Bloody nose
D. Backache
E. Headaches -
- 37.
What drug class is raloxifene?
- A.
Antiresorptive
- B.
Anabolic
- C.
Estrogen receptor modulator
Correct Answer
C. Estrogen receptor modulator -
- 38.
So, does raloxifen act as an extrogen agonist or antagonist on both breast and uterus?
- A.
Agonist
- B.
Antagonist
Correct Answer
A. Agonist -
- 39.
What is raloxifene approved for?
- A.
Prevention of postmenopausal osteoporosis
- B.
Treatment of postmenopausal osteoporosis
- C.
Both prevention and treatment of postmenopausal osteoporosis
Correct Answer
C. Both prevention and treatment of postmenopausal osteoporosis -
- 40.
Are there any clinicla trials that showed any effectiveness against spine fractures for raloxifene?
- A.
Yes
- B.
No
Correct Answer
A. Yes -
- 41.
Whatr drug class is Parathyroid hormone (teriparatide)
- A.
Antiresorptive
- B.
Anabolic
- C.
Estrogen receptor modulator
Correct Answer
B. Anabolic -
- 42.
PTH (teriparatide) is the ONLY anabolic medication that builds new bone. True or false?
- A.
True
- B.
False
Correct Answer
A. True -
- 43.
Therefore PTH (teriparatide) works on osteoblasts or osteoclasts?
- A.
Osteoblasts
- B.
Osteoclasts
Correct Answer
A. Osteoblasts -
- 44.
Is PTH (forteo) a slow bone forming stimulator or a rapid bone forming stimulator?
- A.
Slow
- B.
Rapid
Correct Answer
B. Rapid -
- 45.
Teriparatide should be used as a first line drug. True or false?
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
It is not usually used as a first line drug. It is usually reserved for postmenopausal women who have a very high risk of fracture and those who are unresponsive or intolerant to other osteoporosis medications.Rate this question:
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- 46.
If a patient has a sarcoma, is it appropriate to give them teriparatide?
- A.
Yes
- B.
No
Correct Answer
B. NoExplanation
patients with sarcoma or hypercalcemia should not be given teriparatide.Rate this question:
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- 47.
Can bisphophonates cause osteonecrosis of the jaw?
- A.
Yes
- B.
No
Correct Answer
A. YesExplanation
May 2004 - Adverse event reporting database found 152 cases associated with all bisphophonates.Rate this question:
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- 48.
Is the link between bisphophonates and osteonecrosis of the jaw associated with PO or IV forms of bisphosphonate administration?
- A.
PO
- B.
IV
Correct Answer
B. IV -
- 49.
Osteonecrosis of the jaw has been associated with patients undergoing dental procedures who have cancer and are receiving IV bisphosphonates. True or false?
- A.
True
- B.
False
Correct Answer
A. True -
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