Question 1

The drug recommended as the primary treatment for osteoporosis in women over age 70 is:&#10;A)Alendronate (Fosamax)&#10;B)Premarin (estrogen)&#10;C)Calcium carbonate&#10;D)Raloxifene (Evista)&#10;

Accepted Answer

Alendronate (Fosamax) is a bisphosphonate that is commonly recommended as the primary treatment for osteoporosis in women over age 70, as it helps to prevent bone loss and reduce the risk of fractures.

Question 2

What is the role of calcium supplements when patients take bisphosphonates?&#10;A)They must be restricted to allow the medication to work.&#10;B)They must be taken in sufficient amounts to provide foundational elements for bone growth.&#10;C)They must be taken at the same time as the bisphosphonates.&#10;D)They only work with bisphosphonates if daily intake is unrestricted.&#10;

Accepted Answer

Calcium supplements are important when taking bisphosphonates because they provide the necessary calcium for bone growth and repair, which the bisphosphonates help to incorporate into the bones by reducing bone breakdown.

Question 3

Bisphosphonates treat or prevent osteoporosis by:&#10;A)Inhibiting osteoclastic activity&#10;B)Fostering bone resorption&#10;C)Enhancing calcium uptake in the bone&#10;D)Strengthening the osteoclastic proton pump&#10;

Accepted Answer

Bisphosphonates work by inhibiting the activity of osteoclasts, which are cells responsible for bone resorption, thereby slowing down the process of bone loss and helping to treat or prevent osteoporosis.

Question 4

Angela is a black woman who has heard that women of African descent do not need to worry about osteoporosis. What education would you provide to Angela about her risk?&#10;A)She is correct, black women do not have much risk of developing osteoporosis due to their dark skin.&#10;B)Black women as a group are at risk of developing osteoporosis due to their lower calcium intake when young.&#10;C)If she doesn't drink alcohol, her risk of developing osteoporosis is low.&#10;D)If she has not lost more than 10% of her weight lately, her risk is low.&#10;

Accepted Answer

Black women, while having a lower risk of osteoporosis compared to their white counterparts, are still at risk, particularly due to factors like lower calcium intake during youth. This risk is not negated by skin color, alcohol consumption, or recent weight loss.

Question 5

Bisphosphonate administration education includes:&#10;A)Taking it on a full stomach&#10;B)Sitting erect for at least 30 minutes afterward&#10;C)Drinking it with orange juice&#10;D)Taking it with H2 blockers or proton pump inhibitors (PPIs) to protect the stomach&#10;

Accepted Answer

Bisphosphonates should be taken with a full glass of water while the patient is sitting or standing to prevent esophageal irritation or damage. Patients are advised to remain upright for at least 30 minutes after taking the medication to ensure it reaches the stomach quickly and to reduce the risk of esophageal irritation.

Question 6

Selective estrogen receptor modifiers (SERMs) treat osteoporosis by selectively:&#10;A)Inhibiting magnesium resorption in the kidneys&#10;B)Increasing calcium absorption from the gastrointestinal (GI) tract&#10;C)Acting on the bone to inhibit osteoblast activity&#10;D)Acting on the estrogen receptors in the bone&#10;

Accepted Answer

Selective estrogen receptor modifiers (SERMs) treat osteoporosis by acting on the estrogen receptors in the bone, mimicking the protective effect of estrogen on bone density without the hormone's effects on other tissues.

Question 7

The drug recommended as treatment for osteoporosis in men over age 70 is:&#10;A)Alendronate (Fosamax)&#10;B)Ibandronate (Boniva)&#10;C)Calcium carbonate&#10;D)Raloxifene (Evista)&#10;

Accepted Answer

Alendronate (Fosamax) is recommended for the treatment of osteoporosis in men over age 70, as it is a bisphosphonate that helps prevent bone loss and increases bone mass, which may prevent bone fractures.

Question 8

Drugs that increase the risk of osteoporosis include:&#10;A)Oral combined contraceptives&#10;B)Carbamazepines&#10;C)Calcium channel blockers&#10;D)High doses of vitamin D&#10;

Accepted Answer

Carbamazepine, an anticonvulsant medication, can increase the risk of osteoporosis by interfering with the metabolism of vitamin D and decreasing bone density over time.

Question 9

What is the established frequency of repeating DEXA imaging for a patient on bisphosphonates?&#10;A)&#9;Every two years&#10;B)&#9;Every five years&#10;C)&#9;There is no evidence-based time line for monitoring after the first two years&#10;D)&#9;There should be annual exams&#10;

Accepted Answer

The established frequency of repeating DEXA imaging for a patient on bisphosphonates does not have a specific evidence-based timeline after the first two years. The decision to perform subsequent DEXA scans should be based on individual patient risk factors and treatment response.

Question 10

Besides osteoporosis, intravenous (IV) bisphosphonates are also indicated for:&#10;A)Paget's disease&#10;B)Early osteopenia&#10;C)Renal cancer&#10;D)Early closure of cranial sutures&#10;

Accepted Answer

Intravenous bisphosphonates are indicated for Paget's disease, which involves the abnormal breakdown and formation of bone, leading to bone deformities. Bisphosphonates help regulate bone metabolism in this condition. They are not typically used for early osteopenia, renal cancer, or early closure of cranial sutures.

Question 11

Prophylactic use of bisphosphonates is recommended for patients with advancing osteopenia related to long-term use of which of the following drugs?&#10;A)Selective estrogen receptor modulators&#10;B)Aspirin&#10;C)Glucocorticoids&#10;D)Calcium supplements&#10;

Accepted Answer

The answer of Prophylactic use of bisphosphonates is recommended for...

Question 12

Inadequate vitamin D intake can contribute to the development of osteoporosis by:&#10;A)Increasing calcitonin production&#10;B)Increasing calcium absorption from the intestine&#10;C)Altering calcium metabolism&#10;D)Stimulating bone formation&#10;

Accepted Answer

The answer of Inadequate vitamin D intake can contribute to...

Question 13

The ongoing monitoring for patients over age 65 taking alendronate (Fosamax) or any other bisphosphonate is:&#10;A)Annual dual-energy x-ray absorptiometry (DEXA) scans&#10;B)Annual vitamin D level&#10;C)Annual renal function evaluation&#10;D)Electrolytes every three months&#10;

Accepted Answer

The answer of The ongoing monitoring for patients over age...

Question 14

Both men and women experience bone loss with aging. The bones most likely to demonstrate significant loss that results in major impairment are:&#10;A)Cortical bones&#10;B)Femoral neck bones&#10;C)Cervical vertebrae&#10;D)Pelvic bones&#10;

Accepted Answer

The answer of Both men and women experience bone loss...

Question 15

IV forms of bisphosphonates are used for all of the following except:&#10;A)Severe gastric irritation with oral forms&#10;B)Known cancer metastasis into the bone&#10;C)Advancing renal dysfunction&#10;D)Progression of bone loss with oral formulations&#10;

Accepted Answer

The answer of IV forms of bisphosphonates are used for...

Question 16

How do bisphosphonates treat osteoporosis?&#10;A)By selectively activating estrogen pathways in the bone&#10;B)By reducing bone resorption by inhibiting parathyroid hormone (PTH)&#10;C)By reducing bone resorption and inhibiting osteoclastic activity&#10;D)By increasing PTH production&#10;

Accepted Answer

The answer of How do bisphosphonates treat osteoporosis?&#10;A)By selectively activating...

Deck 21: Drugs Affecting the Bones and Joints