Deck 25: Nutrition and Bone Health

Question 1

Which of the following drug treatments has NOT been proven effective in preventing excessive bone loss?

A)Alendronate
B)Calcitonin
C)Fluoride
D)Bisphosphonate

Answer 1

C
Although use of fluoride is effective in dental applications, because of alterations in the size and structure of hydroxyapatite crystals in the bone, the mechanical competence of the bone is impaired.Alendronate, a type of bisphosphonate, alone or in combination with selective estrogen receptor modulators, is effective in protecting against fracture development.Calcitonin blocks the activation of osteoclasts by PTH and has been shown to improve BMD.

Question 2

What is the most beneficial type of exercise to include in an exercise program for a patient at risk for osteoporosis?

A)Swimming
B)Weight bearing
C)Non-weight bearing
D)Isometric

Answer 2

B
Weight-bearing activities place stress on the skeleton and stimulate osteoblast activity during the developmental periods of bone accretion.Swimming, regular walking, and isometrics do not place as much stress on the skeleton and are not associated with improvements in BMD.

Question 3

When is the peak bone mass of a female typically achieved?

A)By the end of adolescence
B)By approximately 30 years of age
C)Within the decade preceding menopause
D)After the onset of menopause

Answer 3

B
Peak bone mass occurs by about 30 years of age.Through adolescence, the opportunity exists to increase bone mineral density by promoting calcium intake, maintaining weight-bearing activity, and limiting use of alcohol and cigarettes.Around the age of 40 years, BMD gradually declines.After menopause, the rate of loss averages from 1% to 2% per year.

Question 4

Which of the following is associated with the bone tissue at the end of the long bones?

A)Trabecular bone
B)Cortical bone
C)Haversian systems
D)Osteons

Question 5

Which of the following bone measurements is more appropriate for individuals from late adolescence to the elderly years?

A)BMC
B)BMD
C)PBM
D)Alkaline phosphatase

Question 6

Which of the following statements about exercise and bone is TRUE?

A)Regular weight-bearing exercise has little influence on BMD.
B)Upper-body strength activities may improve overall BMD.
C)Walking several miles each day has a large impact on hip BMD.
D)Swimming regularly has a large impact on vertebral BMD.

Question 7

Which of the following dietary variables is NOT related to low bone mass?

A)Inadequate calcium
B)Excessive phosphorus
C)Inadequate vitamin D
D)Excessive potassium

Question 8

Which of the following is a characteristic of type II or age-related osteoporosis?

A)Occurs after 50 years of age
B)Loss of height occurs
C)Only affects trabecular bone
D)Rarely occurs in males

Question 9

Which of the following is NOT a risk associated with excessive calcium supplementation?

A)Constipation
B)Iron deficiency
C)Urinary tract stones
D)High blood pressure

Question 10

Bone tissue consists of the mineral phase and the organic _____ phase.

A)collagen
B)cartilage
C)matrix
D)osteocalcin

Question 11

The WHO's definition of osteoporosis is a BMD greater than _____ standard deviations below the mean for healthy 20- to 29-year-old adults.

A)1
B)1.5
C)2
D)2.5

Question 12

Which of these is NOT a risk factor for developing osteoporosis?

A)Hispanic ethnicity
B)European or Asian ethnicity
C)Cigarette smoking
D)Female athlete triad

Question 13

Which of the following changes related to nutrition and bone metabolism does NOT occur in elderly subjects?

A)Decreased intake of protein
B)Reduction of skin biosynthesis of vitamin D
C)Increased renal excretion of calcium
D)Decline in osteoblast function

Question 14

A chronic elevation of which circulating hormone typically leads to an increase in bone resorption and bone loss?

A)Thyroid hormone
B)Parathyroid hormone
C)Corticosteroid hormone
D)Glucagon

Question 15

Which of the following female patients is at risk for osteoporosis?

A)An African American woman who was normal age at menopause and has a large frame and poor intake of calcium
B)A white woman who is overweight, had multiple pregnancies and late menopause, and consumes alcohol
C)A white woman who is underweight, had premature menopause, does not exercise, and smokes cigarettes
D)An Asian woman who is premenopausal and has a large frame, a high calcium intake, and a sedentary lifestyle

Question 16

Which of the following is necessary for the maturation of osteocalcin?

A)Vitamin K
B)Vitamin D
C)Vitamin E
D)Vitamin A

Question 17

Which of the following are bone-forming cells?

A)Osteocytes
B)Osteoblasts
C)Osteoclasts
D)Osteocalcins

Question 18

Which of the following is NOT a characteristic of hormone-related (type I) osteoporosis?

A)Rapid rate of bone loss and therefore of BMD
B)Cessation of ovarian estrogen production
C)Decrease in dietary calcium intake
D)Increased risk of fracture of wrist and vertebrae

Question 19

What does uncoupling of bone remodeling mean?

A)Bone formation precedes bone resorption.
B)Bone formation both exceeds and precedes bone resorption.
C)Bone resorption precedes bone formation.
D)Bone resorption both precedes and exceeds bone formation.

Question 20

Calcium and phosphate ions in a ratio of ________are needed for bone mineralization.

A)2:1
B)4:1
C)1:1
D)1:2