Osteoporosis (2) (Msq Drill 159)

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.

Submit

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

12. What is raloxifene approved for?

Prevention of postmenopausal osteoporosis

Treatment of postmenopausal osteoporosis

Both prevention and treatment of postmenopausal osteoporosis

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

Yes

No

patients with sarcoma or hypercalcemia should not be given teriparatide.

Explanation

patients with sarcoma or hypercalcemia should not be given teriparatide.

14. Can bisphophonates cause osteonecrosis of the jaw?

Yes

No

May 2004 - Adverse event reporting database found 152 cases associated with all bisphophonates.

Explanation

May 2004 - Adverse event reporting database found 152 cases associated with all bisphophonates.

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

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

Submit

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

18. Which of the following are also used to treat osteoporosis?

Exercise

Bisphophonates

Calcitonin

PTH

Estrogen

Submit

19. Osteoporosis by itself it very painful. True or false?

True

False

by itself osteoporosis is painless.

Explanation

by itself osteoporosis is painless.

21. Boniva is a _______ bisphosphonate.

Daily

Weekly

Monthly

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

Explanation

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

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

Vertebral

Nonvertebral

There is no data on prevention of other types of fractures.

Explanation

There is no data on prevention of other types of fractures.

24. What drug class is raloxifene?

Antiresorptive

Anabolic

Estrogen receptor modulator

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

3%

3.5%

4%

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

28. Menopausal women should take about how much calcium per day?

1200mg

1500mg

1000mg

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

1200mg

1000mg

1500mg

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

True

False

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.

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.

32. Bisphosphonates are classified as anabolic medications. True or false?

True

False

Bisphosphonates are antiresorptive or bone retaining medications.

Explanation

Bisphosphonates are antiresorptive or bone retaining medications.

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

True

False

It is not very effective as monotherapy for future fracture reduction.

Explanation

It is not very effective as monotherapy for future fracture reduction.

34. Which of the following are adverse effects of injected calcitonin?

Backache

Headaches

Nausea/vomiting

Allergic response

Submit

35. Which of the following are adverse reactions of nasal calcitonin?

Nasal irritation

Runny nose

Bloody nose

Backache

Headaches

Submit

37. Whatr drug class is Parathyroid hormone (teriparatide)

Antiresorptive

Anabolic

Estrogen receptor modulator

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

Osteoblast

Osteoclast

This is how they prevent the osteoclasts from resorbing bone.

Explanation

This is how they prevent the osteoclasts from resorbing bone.

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

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

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

The rest of the medications are antiresorptives or bone retaining medications.

Explanation

The rest of the medications are antiresorptives or bone retaining medications.

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.)

Submit

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

Patients uder 70 should take 400IU.

Explanation

Patients uder 70 should take 400IU.

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

Submit

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

1%

1.5%

2.5%

2.6%

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

Painless

From compressive loading

Fom deceleration acceleration

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