Osteoporosis (2) (Msq Drill 159)

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  • 1/49 Questions

    In other words the increased risk of fractures as we move further away from the mean is NOT linear. True or false?

    • True
    • False
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  • 2. 

    Can you use calcium and vitamin D in the treatment regimen of osteoporosis?

    • Yes

    • No

    Correct Answer
    A. Yes
  • 3. 

    Which of the following can be done to prevent or treat osteoporosis?

    • Counsel all patients on risk reduction

    • Instruct all patients on adequate daily intake of calcium and vitamin D

    • Provide guidelines for regular participation in weight bearing and muscle strengthening exercises to reduce the risk of falls and fractures

    • Provide strategies for fall prevention

    • Counsel all patients on avoiding tobacco smoking and excessive alcohol intake.

    Correct Answer(s)
    A. Counsel all patients on risk reduction
    A. Instruct all patients on adequate daily intake of calcium and vitamin D
    A. Provide guidelines for regular participation in weight bearing and muscle strengthening exercises to reduce the risk of falls and fractures
    A. Provide strategies for fall prevention
    A. Counsel all patients on avoiding tobacco smoking and excessive alcohol intake.
  • 4. 

    Patients with a calcium deficiency should supplement their calcium in order to meet the recommeded daily intake. True or false?

    • True

    • False

    Correct Answer
    A. True
  • 5. 

    Can weight bearing exercise such as walking reduce fractures?

    • Yes

    • No

    Correct Answer
    A. Yes
  • 6. 

    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?

    • Antiresorptive

    • Anabolics

    Correct Answer
    A. Antiresorptive
  • 7. 

    Which of the two classes of medications used to treat osteoporosis  works on bone forming actitivy?

    • Antiresorptives

    • Anabolics

    Correct Answer
    A. Anabolics
  • 8. 

    So, do bisphophonates lead to an increase in bone mineral density and reduced fracture rates?

    • Yes

    • No

    Correct Answer
    A. Yes
  • 9. 

    Can you prescribe both bisphosphonates and cacium/vitamin D?

    • Yes

    • No

    Correct Answer
    A. Yes
  • 10. 

    Is calcitonin an antiresorptive or anabolic medication?

    • Antiresorptive

    • Anabolic

    Correct Answer
    A. Antiresorptive
  • 11. 

    Calcitonin is administered either nasal spray or injectable. True or false?

    • True

    • False

    Correct Answer
    A. True
  • 12. 

    What is raloxifene approved for?

    • Prevention of postmenopausal osteoporosis

    • Treatment of postmenopausal osteoporosis

    • Both prevention and treatment of postmenopausal osteoporosis

    Correct Answer
    A. Both prevention and treatment of postmenopausal osteoporosis
  • 13. 

    If a patient has a sarcoma, is it appropriate to give them teriparatide?

    • Yes

    • No

    Correct Answer
    A. No
    Explanation
    patients with sarcoma or hypercalcemia should not be given teriparatide.

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  • 14. 

    Can bisphophonates cause osteonecrosis of the jaw?

    • Yes

    • No

    Correct Answer
    A. Yes
    Explanation
    May 2004 - Adverse event reporting database found 152 cases associated with all bisphophonates.

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  • 15. 

    Osteonecrosis of the jaw has been associated with patients undergoing dental procedures who have cancer and are receiving IV bisphosphonates. True or false?

    • True

    • False

    Correct Answer
    A. True
  • 16. 

    Which of the following are potential utilities for bone density measurement?

    • Helps to assess future fracture risk

    • Helps to confirm diagnosis of osteoporosis

    • Helps to monitor effects of treatment

    • Helps to assess rate of bone loss

    • Helps to enhance the patient's acceptance of and compliance with treatment

    Correct Answer(s)
    A. Helps to assess future fracture risk
    A. Helps to confirm diagnosis of osteoporosis
    A. Helps to monitor effects of treatment
    A. Helps to assess rate of bone loss
    A. Helps to enhance the patient's acceptance of and compliance with treatment
  • 17. 

    *** The WHO criteris for a diagnosis of osteoporosis is:

    • a T score -1.0 to -2.5 SD

    • < or equal to -2.5 SD (with fragility fractures)

    • < or equal to -2.5 SD

    • > or equal to -1.0 SD

    Correct Answer
    A. < or equal to -2.5 SD
  • 18. 

    Which of the following are also used to treat osteoporosis?

    • Exercise

    • Bisphophonates

    • Calcitonin

    • PTH

    • Estrogen

    Correct Answer(s)
    A. Exercise
    A. Bisphophonates
    A. Calcitonin
    A. PTH
    A. Estrogen
  • 19. 

    Osteoporosis by itself it very painful. True or false?

    • True

    • False

    Correct Answer
    A. False
    Explanation
    by itself osteoporosis is painless.

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  • 20. 

    Do most people meet the daily requirements of Vitamin D intake?

    • Yes

    • No

    Correct Answer
    A. No
  • 21. 

    Boniva is a _______ bisphosphonate.

    • Daily

    • Weekly

    • Monthly

    Correct Answer
    A. Monthly
    Explanation
    there is now a q3monthly IV option now available. Results are comparable (50%) rductionin vertebral fractures in those with and without fracture history.

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  • 22. 

    Calcitonin has been shown to decrease the risk of what types of fractures only?

    • Vertebral

    • Nonvertebral

    Correct Answer
    A. Vertebral
    Explanation
    There is no data on prevention of other types of fractures.

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  • 23. 

    Calcitonin has been shown to decrease pain associated with vertebral fractures. True or false?

    • True

    • False

    Correct Answer
    A. True
  • 24. 

    What drug class is raloxifene?

    • Antiresorptive

    • Anabolic

    • Estrogen receptor modulator

    Correct Answer
    A. Estrogen receptor modulator
  • 25. 

    Therefore PTH (teriparatide) works on osteoblasts or osteoclasts?

    • Osteoblasts

    • Osteoclasts

    Correct Answer
    A. Osteoblasts
  • 26. 

    What about fracture risk with 2.5 standard deviation in bone mineral density. What is the fracture risk?

    • 3%

    • 3.5%

    • 4%

    • 10%

    Correct Answer
    A. 10%
  • 27. 

    What is the most common nonvertebral fracture in white women until the age of 75?

    • Proximal fibula

    • Distal radius

    • Proximal ulna

    • Proximal femur

    • Hip

    Correct Answer
    A. Distal radius
  • 28. 

    Menopausal women should take about how much calcium per day?

    • 1200mg

    • 1500mg

    • 1000mg

    Correct Answer
    A. 1200mg
  • 29. 

    Women and men over the age of 65 should take how much calcium?

    • 1200mg

    • 1000mg

    • 1500mg

    Correct Answer
    A. 1500mg
  • 30. 

    So, does raloxifen act as an extrogen agonist or antagonist on both breast and uterus?

    • Agonist

    • Antagonist

    Correct Answer
    A. Agonist
  • 31. 

    Teriparatide should be used as a first line drug. True or false?

    • True

    • False

    Correct Answer
    A. False
    Explanation
    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.

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  • 32. 

    Bisphosphonates are classified as anabolic medications. True or false?

    • True

    • False

    Correct Answer
    A. True
    Explanation
    Bisphosphonates are antiresorptive or bone retaining medications.

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  • 33. 

    Calcitonin is also an effective monotherapy for future fracture reduction. True or false?

    • True

    • False

    Correct Answer
    A. False
    Explanation
    It is not very effective as monotherapy for future fracture reduction.

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  • 34. 

    Which of the following are adverse effects of injected calcitonin?

    • Backache

    • Headaches

    • Nausea/vomiting

    • Allergic response

    Correct Answer(s)
    A. Backache
    A. Headaches
    A. Nausea/vomiting
    A. Allergic response
  • 35. 

    Which of the following are adverse reactions of nasal calcitonin?

    • Nasal irritation

    • Runny nose

    • Bloody nose

    • Backache

    • Headaches

    Correct Answer(s)
    A. Nasal irritation
    A. Runny nose
    A. Bloody nose
    A. Backache
    A. Headaches
  • 36. 

    Are there any clinicla trials that showed any effectiveness against spine fractures for raloxifene?

    • Yes

    • No

    Correct Answer
    A. Yes
  • 37. 

    Whatr drug class is Parathyroid hormone (teriparatide)

    • Antiresorptive

    • Anabolic

    • Estrogen receptor modulator

    Correct Answer
    A. Anabolic
  • 38. 

    PTH (teriparatide) is the ONLY anabolic medication that builds new bone. True or false?

    • True

    • False

    Correct Answer
    A. True
  • 39. 

    Bisphosphonates bind to hydroxyapatite crystals in the bone and _________ bone interface.

    • Osteoblast

    • Osteoclast

    Correct Answer
    A. Osteoclast
    Explanation
    This is how they prevent the osteoclasts from resorbing bone.

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  • 40. 

    At what T-score should you use bisphophonates?

    • Below 1.0 from SD

    • Below 1.5 from SD

    • Below 2.0 from SD

    • Below 2.5 from SD

    Correct Answer
    A. Below 2.0 from SD
  • 41. 

    Calcitonin is prescribed to women who cannot tolerate other osteoporosis medications. Nevertheless these women should be at least how many years post menopausal?

    • 1

    • 2

    • 3

    • 4

    • 5

    Correct Answer
    A. 5
  • 42. 

    Is PTH (forteo) a slow bone forming stimulator or a rapid bone forming stimulator?

    • Slow

    • Rapid

    Correct Answer
    A. Rapid
  • 43. 

    Is the link between bisphophonates and osteonecrosis of the jaw associated with PO or IV forms of bisphosphonate administration?

    • PO

    • IV

    Correct Answer
    A. IV
  • 44. 

    Which of the following medications that are all used in the treatment of osteoporosis is an anabolic or bone forming medication?

    • Bisphosphonates (alendronate, ridendronate and ibandronate)

    • Calcitonin

    • Parathyroid hormone therapy (PTH 1-34, teriparatide)

    • Estrogen /hormone therapy

    • Raloxifene

    Correct Answer
    A. Parathyroid hormone therapy (PTH 1-34, teriparatide)
    Explanation
    The rest of the medications are antiresorptives or bone retaining medications.

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  • 45. 

    When administering bisphosphonates what should you tell your patients?

    • To take it in the evening

    • To take it in the morning

    • To takes it 30 minutes before taking anything by mouth

    • To take it either standing up or sitting upright in bed

    • To take it with 8ounces of plain water (no juice, no other medications.)

    Correct Answer(s)
    A. To take it in the evening
    A. To take it in the morning
    A. To takes it 30 minutes before taking anything by mouth
    A. To take it either standing up or sitting upright in bed
    A. To take it with 8ounces of plain water (no juice, no other medications.)
  • 46. 

    The NIH guidelines for vitamin D state that patients above the age of 70 should take how much vitamin D?

    • 400IU

    • 600IU

    • 800IU

    • 1000IU

    Correct Answer
    A. 600IU
    Explanation
    Patients uder 70 should take 400IU.

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  • 47. 

    In which of the following will you initiate pharmacologic therapy according to NOF recommendations?

    • BMD T-score below -2.0 by DXA with no risk factors

    • BMD T-score below -1.5 by DXA with one or more risk factors

    • History of a prior fracture of hip fracture

    • 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
    A. BMD T-score below -1.5 by DXA with one or more risk factors
    A. History of a prior fracture of hip fracture
  • 48. 

    Up to 1 standard deviation drop in bone mineral density the fracture risk increases by:

    • 1%

    • 1.5%

    • 2.5%

    • 2.6%

    Correct Answer
    A. 2.6%
  • 49. 

    When patients with osteoporosis have a spinal fracture it is usually:

    • Painless

    • From compressive loading

    • Fom deceleration acceleration

    Correct Answer(s)
    A. Painless
    A. From compressive loading

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  • Feb 16, 2019
    Quiz Edited by
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