Osteoporosis (1) (Msq Drill 160)

1. How do we measure bone density?

CT scan

PET scan

MRI

DXA scan

2. If a localized area has low bone density, does this meet the criteria for osteoporosis?

Yes, any low bone density meets the criteria for osteoporosis

3. So, bone strength + bone density + bone quality. True or false?

True

False

4. Since estrogen is a bone protector women who are postmenopausal are at a high risk of getting osteoporosis as they have an ______ amount of estrogen.

Increased

Decreased

5. Can neoplasms activate osteoclast activity leading to osteoporosis?

Yes

No

6. So heredity and your body frame can put you at risk for osteoporosis?

Yes

No

7. The less you move around, the greater the chance of developing osteoporosis. True or false?

True

False

8. Can your risk of developing osteoporosis be affected by your race?

Yes

No

9. Do hip fractures also increase exponentially as women age?

Yes

No

10. Calcium is an intergral component of the bone matrix. True or false?

True

False

11. Testing and increased life expectancy has seen higher numbers of people diagnosed today than before. True or false?

True

False

12. Although trabecular bone has 80% turnover it only comprises 20% of the skeletal mass. True or false?

True

False

13. What is osteoporosis characterized by low bone density or low bone quality?

Low bone density or mass

Low bone quality

14. Is there bone thinning in osteoporosis?

Yes

No

15. Everything else that causes osteoporosis besides aging and postmenopause is considered a ______ cause of osteoporosis.

Primary

Secondary

Physiologic

16. The major health care cost of osteoporosis comes from:

Doctor visits

Osteoporosis medications

Fractures

17. What two types of cells are associated with osteoporosis?

Osteoblasts

Osteocytes

Osteoclasts

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18. Between cortical and trabeculae bone which one has a higher turnover?

Trabecular

Cortical

19. Osteopenia is classified as a bone mass density that is __________ standard deviations below the young normal female mean.

2-2.5

1-2.5

1-3.5

20. Both the cortical and trabecular parts of bone are affected by osteoporosis. Which part is affected more?

Trabeculae

Cortex

21. Is estrogen a mjor bone deteriorator or a bone protector?

Bone deteriorator

Protector

22. Men do NOT get osteoporosis. True or false?

True

False

In fact men are underdiagnosed.

Explanation

In fact men are underdiagnosed.

23. Which of the following are also other secondary causes of osteoporosis?

Endocrine disorders such as cushings and hyperthyroidism

Vitamin D deficiency

Hepatic and renal dysfunction

Malnutrition, anorexia nervosa

Celiac disease and other causes of malabsorption

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24. Between estrogen and testosterone which one is protective from osteoporosis?

Estrogen ony

Testosterone only

Both estrogen and testosterone

25. What does osteopenia mean?

Wasting away of bone trabeculae

Extensive thinning of bone

Mild thinning of the bone mass

26. What is the WHO classification for Osteoporosis?

Bone mass density over 2.5 standard deviations below the normal female mean

Bone mass density between 1-2.5 standard deviations below the normal female mean (T score)

27. When you tell a patient that they have osteomalacia, you are essentially telling them that they have a problem with their bone:

Density

Quality

Problems with bone density lead to osteoporosis.

Explanation

Problems with bone density lead to osteoporosis.

28. Why might a man be at risk for osteoporosis? Check all that apply.

Low testosterone levels

High testosterone levels

Heavy alcohol consumption

Smoking

Glucocorticoid use

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29. The majority of men with osteoporosis have disorders that are known to produce bone loss. Which of the following are some of these disorders?

Hyperparathyroidism

Hypoparathyroidism

Malignancies

Intestinal disorders

Conditions resulting in immobilization

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30. Of the two types of cells associated with osteoporosis, which one has increased activity in malignancies?

Osteoblasts

Osteoclasts

31. Is osteoporosis a systemic or a localized disease?

Systemic

Localized

32. So, is the bone quality in osteoporosis normal?

Yes

No

33. The national osteoporosis foundation defines osteopenia as up to 2 standard deviations below young normal females. True or false?

True

False

34. Which group of drugs top the list of drugs that can cause osteoporosis?

Anticonvulsants

Depo provera

Heparin

Glucocorticoids

Thyroid horone replacements

35. What is the number secondary cause of osteoporosis?

Premature ovarian failure

Steroids

Diabetes mellitus

Testicular insufficiency

Immobilization

36. Because patients with osteoporosis have low bone density they have fragile bones and are prone to fractures. According to the national National Osteoporosis foundation ostoporosis is defined as:

Below 2 standard deviations

Up to 2 standard deviations below young normal females

37. Osteoporosis is defined as a skeletal disorder characterized by compromised bone strength predisposing to an increased risk of fractures. Bone strength reflects the intergration of what two main features?

Bone water content

Bone quality

Bone cortical tensegrity

Bone density

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38. Which cell is responsible for bone resorption?

Osteoclasts

Osteoblasts

39. So, the consequences of osteoporosis include:

Bone fragility

Bone remodelling

Fracture

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40. Aging and postmenopause are ________ causes of osteoporosis.

Physiologic

Secondary

41. If you are giving your patient a dose of steroids that is above _______ mg, it is extremely important to include a concomitant prophylaxis against osteoporosis such as Actonel or Boniva.

3.5mg

4.5mg

5.6mg

7.5mg

9mg

42. What percentage of women over the age of 50 will sustain a fracture in their lifetime?

10%

20%

30%

40%

50%

43. Which of the following are other risk factors for osteoporosis?

High body mass

Hypocalcemia

Smoking and alcohol

Family history of fractures

Female

Patients who have a low body mass have a higher risk of osteoporosis.

Explanation

Patients who have a low body mass have a higher risk of osteoporosis.

Submit

44. In studies on white women and the fracture risk associated with the aging process, what type of fractures increased the most as women grew older?

Vertebral

Hip

Colles

45. How many americans currently have low bone mass?

12 million

17 million

28 million

11 million

34 million

46. Bone mineral density accounts for what percentage of total bone strength?

20%

50%

70%

75%

47. Which of the following are clinical features of spinal osteoporosis?

Numerous warning signs

Height loss and dorsal kyphosis

Paraspinal muscle pain

Restrictive lung disease

Protruberant lower abdomen with early satiety, bloating and nausea

spinal osteoporosis has NO early warning signs.

Explanation

spinal osteoporosis has NO early warning signs.

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48. What is the most common vertebral compression fractures due to osteoporosis?

C2

T4

T7

T12

L4

49. Osteoporosis causes over how may million fractures in men and women over the age of 50?

1

2

3

4

5

50. Osteoporosis is the most common METABOLIC bone disease in:

The population

Women

Men

The elderly

51. How many women and men in the US currently have osteoporosis respectively?

2 and 5 million

8 and 6 million

9 and 3 million

8 and 2 million

52. The following are all biochemical markers of bone metabolism. Which ones are involved in bone formation?

Free deoxypyridinoline

Serum osteocalcin

Urinary collagen type 1 cross linked N-telopeptide

Urinary collagen type 1 cross linked C-telopeptide

Serum bone specific alkaline phosphatase

the rest are responsible for bone resorption.

Explanation

the rest are responsible for bone resorption.

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53. The DXA scan is used to measure bone mineral density. What skeletal features are measured?

Radius

Ulna

Lumbar spine

Greater trochanter

Tibia

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54. Which of the following are some secondary risk factors for osteoporosis?

Depo provera

Dilantin

Chronic heparin therapy

Chronic protein or clacium deficiency

Thyroid hormone deficiency

Patients with an excess of thyroid hormone are at risk for osteoporosis.

Explanation

Patients with an excess of thyroid hormone are at risk for osteoporosis.

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