Answer each of the
following questions (there is only one correct answer to each question).
1
The percentage of older Americans with fractured hips
that will die from complications within a year of the fracture is:
A. 5% to 10%
B. 15% to 30%
C. 25% to 40%
D. 50% or more
2
Bone collagen is made of:
A. chains of peptide molecules
B. layers of calcium crystals
C. large sheets of hydroxyapatite
D. dense bricks containing carbon and iron
3
Trabecular bone is found primarily:
A. on the outside of the long bones of the legs
and arms
B. in the inner cavities of the bones, along
with marrow and fat
C. throughout the skull and pelvis
D. within the Haversian system of the cortical
bone
4
In addition to providing a supportive framework for
the body, the skeleton serves as a:
A. site for hormone production
B. filter for environmental toxins
C. storehouse for calcium and other minerals
D. breeding ground for beneficial bacteria
5
Maintenance of appropriate blood calcium levels involves
all of the following except :
A. vitamin D
B. calcitonin
C. strontium
D. parathyroid hormone
6
In order for vitamin D to aid in bone production it
must be converted to its active form in the:
A. skin
B. bone marrow
C. liver and kidneys
D. intestine
7
The cells responsible for bone resorption are known
as:
A. osteoblasts
B. osteoclasts
C. osteocytes
D. all of the above
8
The calcium dissolved as part of the bone repair process:
A. passes into the bloodstream
B. is used onsite for new bone formation
C. neutralizes the acid created in the process
D. assists with further bone erosion
9
The process of bone remodeling, from the initiation
of resorption to the completion of repairs, takes approximately:
A. one week
B. one month
C. three months
D. two years
10
Bone fragility results from reduction of all of the
following except :
A. bone mass
B. bone density
C. cross linkage
D. apoptosis
11
Often, the first warning signal of osteoporosis is:
A. elevated serum calcium
B. perceived loss of strength
C. low back pain
D. a fractured wrist
12
Of the following, the persons at highest risk for osteoporosis-related
fractures are:
A. African American men
B. vegetarians
C. women who have never been pregnant
D. those who had sports related injuries in childhood
13
Significant loss of trabecular bone is likely to cause:
A. crush fractures of the vertebrae
B. spiral fractures of the forearm
C. deformity of the hips
D. shortening of the legs
14
Over time, osteoporosis may cause shrinkage of the entire
spinal column, which may in turn lead to:
A. digestive problems
B. shortness of breath
C. susceptibility to lung infections
D. all of the above
15
The role of estrogen in the bone remodeling process
includes all of the following except :
A. promoting absorption of calcium in the intestine
B. blocking the action of Vitamin D
C. prolonging the life of osteoblasts
D. accelerating the death of osteoclasts
16
Age-related changes that increase risk for osteoporosis
include:
A. decreased excretion of calcium through the
kidneys
B. overproduction of Vitamin D
C. decline in secretion of calcitonin
D. cessation of production of PTH
17
The yearly rate of bone loss for women three to seven
years after menopause averages:
A. 0.3%
B. 0.5%
C. 1%
D. 3%
18
The disorder referred to as the “Hungry Bone Syndrome”
is caused by:
A. overactivity of the parathyroid gland
B. excessive amounts of thyroid hormone
C. pituitary dysfunction
D. fluctuations in estrogen level
19
Factors in patients with rheumatoid arthritis that may
contribute to osteoporosis include:
A. reduced bone calcium content
B. treatment with cortisone
C. use of antacids with anti-inflammatory drugs
D. all of the above
20
Risk for fractures associated with long-term glucocorticoid
use is greatest for:
A. cortical bone
B. trabecular bone
C. legs and hips
D. forearms and wrists
21
Which one of the following medications has not
been implicated in the development of osteoporosis?
A. Lasix
B. Dilantin
C. Zantac
D. Questran
22
At the present time, clinical diagnosis of osteoporosis
is made by:
A. evidence of reduced bone mass on simple x-ray
B. bone density measurement with dual x-ray absorptiometry
C. CT scan of the vertebral column
D. biochemical markers of bone turnover
23
Among American women, calcium intake is:
A. usually well below recommended levels throughout
the lifespan
B. deficient primarily in teenage girls who have
an eating disorder
C. on average 800mg to 1200mg a day in those
over age 35
D. a critical determiner of bone health only
after the menopause
24
How many mg of calcium are contained in one cup (8 oz.)
of milk?
A. 150
B. 250
C. 350
D. 500
25
Consumption of large amounts of phosphorus:
A. is common due to its use in processed foods
and drinks
B. is recommended to prevent secondary hyperparathyroidism
C. may protect the bones of those who have a
low calcium intake
D. all of the above
26
The most common calcium supplement in the U.S. today
is:
A. calcium gluconate
B. calcium chloride
C. calcium phosphate
D. calcium carbonate
27
Use of dolomite and bone meal for calcium supplementation
is not recommended because they have been shown to:
A. cause kidney stones in susceptible people
B. aggravate gastric secretion problems
C. contain trace amounts of toxic metals
D. be poorly absorbed in comparison to other
available preparations
28
The elderly are at greater risk for vitamin D deficiency
because of:
A. limited intake of magnesium and trace minerals
B. decreased exposure to the sun
C. reluctance to use nutritional supplements
D. diets low in protein and fat
29
The best diet for prevention of osteoporosis:
A. is low in protein and high in carbohydrates
B. is based on cereal grains enriched with vitamins
C. emphasizes consumption of citrus fruits
D. contains a high ratio of vegetable to animal
protein
30
Increasing one’s vegetable intake from 3 to 9 servings
a day may:
A. result in a protein deficiency
B. lead to development of metabolic acidosis
C. significantly decrease urinary calcium excretion
D. balance one’s intake of calcium and phosphorus
31
Urinary calcium losses in the elderly may be reduced
by:
A. modest salt restriction
B. magnesium supplementation
C. taking manganese along with a calcium supplement
D. all of the above
32
The synthesis of key proteins in the bone matrix requires
adequate amounts of vitamin:
A. A
B. B12
C. C
D. K
33
The most common bone destroying disease in men under
the age of 60 is:
A. alcoholism
B. arthritis
C. cancer
D. osteoporosis
34
Smoking has been associated with an increase in the
incidence of hip fracture of:
A. 10% - 20%
B. 20% - 40%
C. 40% - 50%
D. 50% - 60%
35
An adequate program of physical activity for the prevention
and treatment of osteoporosis should include:
A. short bursts of strenuous exercise such as
running
B. a comprehensive series of muscle strengthening
exercises
C. three to four hours a week of weight bearing
activity such as walking
D. all of the above
36
The Women’s Health Initiative, a large multicenter
research program, is being undertaken to address:
A. the skeletal benefits of estrogen replacement
B. the most effective nutritional program for
osteoporosis prevention
C. the relationship between bone mineral density
and fracture risk
D. genetic risk factors for bone disease
37
Estrogen therapy for osteoporosis is most beneficial:
A. at the onset of the peri-menopause and continued
for at least ten years
B. during the first five to ten years after the
menopause
C. if begun at the first signs of bone loss
D. in women aged 65 or older
38
Hormone replacement therapy is generally not
recommended for women who have:
A. a close relative with breast cancer
B. diabetes or hypertension
C. problems with phlebitis
D. all of the above
39
A good alternative treatment for those post-menopausal
women who choose not to use hormone replacement therapy is:
A. alendronate
B. raloxifene
C. calcitonin nasal spray
D. ipriflavone
40
As a treatment for osteoporosis, parathyroid hormone
differs from the antiresorptive agents in that it:
A. may cause long-term gastrointestinal problems
B. is better tolerated in elderly patients
C. can be administered in a single infusion per
month
D. may actually alter the architecture of existing
bone
41
Long-term compliance with treatment plans for osteoporosis
may be improved by:
A. switching patients from the bisphosphonates
to HRT
B. aggressively treating medication side effects
C. more frequent monitoring of bone density
D. improving awareness among women and their
physicians
42
The incidence and risk of osteoporosis in men is less
than in women because men have:
A. a higher peak bone mass in early adulthood
B. a shorter life expectancy overall
C. no dramatic hormonal change comparable to
menopause
D. all of the above
43
The pattern of bone loss in men differs from that of
women in that it:
A. is due primarily to reduced bone formation
B. accelerates dramatically about the age of
70
C. occurs mainly in cortical bone
D. results primarily in reduced connectivity
44
Which one of the following medications has been approved
by the FDA for the treatment of steroid-related bone loss in men?
A. estradiol
B. alendronate
C. tamoxifen
D. tibolone
45
Individuals with a milk allergy may be able to increase
their calcium intake by eating:
A. ice cream
B. yogurt
C. cottage cheese
D. hard cheese
46
The substance in spinach and collard greens that inhibits
the body’s absorption of the calcium they contain is:
A. vitamin K
B. magnesium
C. phytate
D. oxalic acid
47
Fruits that are high in calcium include:
A. peaches and nectarines
B. apples and pears
C. oranges and papayas
D. bananas and pineapple
48
Environmental changes that can help an older person
compensate for poor vision include all of the following except :
A. removing throw rugs and other hard to see
obstacles
B. using a consistent low level of illumination
in every room
C. increasing contrast on steps with white paint
D. creating clear paths from room to room
49
Factors contributing to limited mobility in older persons
include:
A. changes in the inner ear
B. decreased joint flexibility
C. alterations in gait pattern
D. all of the above
50
The best way to prevent falls in individuals with dementia
is to:
A. encourage ambulation as much as possible
B. place them in wheelchairs with seat belts
during waking hours
C. use bed rails and other restraints as needed
at night
D. provide adequate levels of supervision
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