Deck 25: Diseases of the Musculoskeletal System

Question 1

Calcium carbonate supplementation can interfere with the absorption of:

A)magnesium.
B)phosphorus.
C)iron.
D)folate.

Answer 1

C

Question 2

Which of the following fatty acids can contribute to the alleviation of inflammation in somebody with rheumatoid arthritis?

A)arachidonic
B)linoleic
C)stearic
D)EPA

Answer 2

D

Question 3

You have a patient who reports the feeling of tetany occurring in both the hands and feet What is the likely cause of these symptoms?

A)hypercalcemia
B)dehydration
C)hypocalcemia
D)hyperkalemia

Answer 3

C

Question 4

Which of the following diseases occurs when the serum concentration of uric acid becomes elevated and crystals form within the synovial fluid?

A)osteoarthritis
B)osteomalacia
C)gout
D)gangrene

Question 5

You have a patient with a T-score of -27; therefore, you can diagnose him/her with:

A)anemia.
B)hypocalcemia.
C)osteoporosis.
D)hypercalcemia.

Question 6

Which of the following is a chronic inflammatory disease in which the synovial membrane of the joints becomes inflamed?

A)osteoarthritis
B)rheumatoid arthritis
C)gout
D)fibromyalgia

Question 7

Which of the following diseases is characterized by inadequate mineralization of the organic matrix within the bones of children?

A)osteomalacia
B)rickets
C)osteoporosis
D)Paget disease

Question 8

Which of the following individuals is most likely to have a low BMD?

A)Maria, who lives in the city and frequently engages in weight resistance exercises
B)John, who lives in a rural community and is a farmer
C)Kim, who is a runner and eats a balanced diet
D)Juan, who lives a sedentary lifestyle and is lactose intolerant

Question 9

Vitamin D increases blood concentrations of calcium and phosphorus by doing all of the following except:

A)promoting absorption via the GI tract.
B)promoting reabsorption via the kidneys.
C)stimulating osteoclast formation.
D)stimulating osteoblast formation.

Question 10

Cigarette smokers are more likely to have an increased risk of poor bone health for all of the following reasons except:

A)tobacco smoke decreases intestinal calcium absorption.
B)nicotine is toxic to osteoblasts.
C)cadmium is toxic to osteoblasts.
D)both nicotine and cadmium inhibit osteoclasts.

Question 11

The active form of vitamin D is:

A)ergocalciferol.
B)cholecalciferol.
C)25-hydroxyvitamin D.
D)1,25-dihydroxyvitamin D.

Question 12

You have a recently diagnosed renal patient Because of this disease and the altered function of the kidneys, which of the following micronutrients must he/she supplement with?

A)vitamin D
B)Fe
C)phosphorus
D)zinc

Question 13

The lower the BMD, the greater the risk that the person will:

A)develop osteoarthritis.
B)develop cysts.
C)contract a communicable disease.
D)fracture a bone.

Question 14

When blood calcium concentration is low the _____ releases _____ in order to raise blood calcium levels

A)parathyroid gland, calcitonin
B)thyroid gland, PTH
C)parathyroid gland, PTH
D)thyroid gland, calcitonin

Question 15

You have recently diagnosed a male with osteoporosis In addition to supplementation with calcium and vitamin D, what other pharmacological treatment should you recommend?

A)biphosphonates
B)estrogen
C)SERM
D)testosterone

Question 16

Inadequate intake of _____ during growth years will result in sub-optimal development of peak bone mass and an increased risk of osteoporosis

A)calcium
B)vitamin D
C)phosphorus
D)magnesium

Question 17

When blood calcium concentration is high the _____ secretes _____ in order to normalize blood calcium levels

A)parathyroid gland, calcitonin
B)thyroid gland, PTH
C)thyroid gland, calcitonin
D)parathyroid gland, PTH

Question 18

You have a patient who just gave birth and she wants to exclusively breast feed the infant What recommendation should you give?

A)In between each feeding, give the baby some water.
B)Breast feed for only 4 months.
C)At 6 months begin to supplement the breast milk with formula.
D)At the beginning of 2 months of age give a multivitamin supplement for infants that contains 200 IU of vitamin D.

Question 19

_____ is characterized by abnormal bone remodeling that is localized, progressive, and often crippling, and that results from overactive osteoclasts

A)Rickets
B)Osteomalacia
C)Osteoporosis
D)Paget disease

Question 20

You have recently diagnosed a lactose intolerant elderly patient with osteoporosis What should you recommend as part of this patient's treatment?

A)vitamin D and calcium supplementation
B)increasing his/her consumption of spinach
C)increasing his/her consumption of milk and yogurt
D)phosphorus and calcium supplementation

Question 21

KL is a 70 yo African American F living in a long-term care facility in upstate New York.She has a history of RA, which was well controlled until recently.She reports taking calcium supplements.She presents to the hospital with a hip fracture following a fall.
All of the following laboratory tests will help the physician to determine if KL has secondary osteoporosis except:

A)serum Ca.
B)DXA.
C)parathyroid hormone.
D)thyroid-stimulating hormone.

Question 22

KL is a 70 yo African American F living in a long-term care facility in upstate New York.She has a history of RA, which was well controlled until recently.She reports taking calcium supplements.She presents to the hospital with a hip fracture following a fall.
Which of the following medications used to treat RA may increase KL's risk for fractures?

A)immunosuppressive drugs
B)NSAIDs
C)glucocorticoids
D)DMARDs

Question 23

KL is a 70 yo African American F living in a long-term care facility in upstate New York.She has a history of RA, which was well controlled until recently.She reports taking calcium supplements.She presents to the hospital with a hip fracture following a fall.
Which dietary supplement will the registered dietitian recommend in order to reduce inflammation?

A)EPA and DHA
B)DHP
C)vitamin C
D)NSAIDs

Question 24

Case Study Multiple Choice
You have a 35 yo F client who comes to see you for outpatient nutritional counseling for osteoporosis.Your client has a history of anorexia nervosa and reports low physical activity.She has recently finished treatment for her anorexia and does not take any medications other than iron for anemia due to her history.
HT: 5'4 WT: 115#
Diet Hx:
B 1 cup plain oatmeal D 1 boneless, skinless chicken breast
1 cup orange juice 1 cup brown rice
¼ cup soybeans
L 2 slices baked ham
1 slice Swiss cheese S 1 cup low-fat chocolate milk
2 slices whole-wheat bread
Lettuce and tomato
1 tsp fat-free mayo
Which food in this client's diet history provides the least calcium?

A)oatmeal
B)soybeans
C)Swiss cheese
D)chocolate milk

Question 25

Although the etiology of fibromyalgia is unknown, it has often been associated with _____

A)a traumatic event
B)toxicity of mercury
C)meningitis
D)a diet that is fat free

Question 26

Case Study Multiple Choice
You have a 35 yo F client who comes to see you for outpatient nutritional counseling for osteoporosis.Your client has a history of anorexia nervosa and reports low physical activity.She has recently finished treatment for her anorexia and does not take any medications other than iron for anemia due to her history.
HT: 5'4 WT: 115#
Diet Hx:
B 1 cup plain oatmeal D 1 boneless, skinless chicken breast
1 cup orange juice 1 cup brown rice
¼ cup soybeans
L 2 slices baked ham
1 slice Swiss cheese S 1 cup low-fat chocolate milk
2 slices whole-wheat bread
Lettuce and tomato
1 tsp fat-free mayo
Which food in this client's diet history provides the most calcium?

A)oatmeal
B)soybeans
C)Swiss cheese
D)chocolate milk

Question 27

Case Study Multiple Choice
You have a 35 yo F client who comes to see you for outpatient nutritional counseling for osteoporosis.Your client has a history of anorexia nervosa and reports low physical activity.She has recently finished treatment for her anorexia and does not take any medications other than iron for anemia due to her history.
HT: 5'4 WT: 115#
Diet Hx:
B 1 cup plain oatmeal D 1 boneless, skinless chicken breast
1 cup orange juice 1 cup brown rice
¼ cup soybeans
L 2 slices baked ham
1 slice Swiss cheese S 1 cup low-fat chocolate milk
2 slices whole-wheat bread
Lettuce and tomato
1 tsp fat-free mayo
Which of the following risk factors for osteoporosis does your client not present with?

A)inactiviy
B)underweight/low BMI
C)history of anorexia nervosa
D)gender

Question 28

Case Study Multiple Choice
You have a 35 yo F client who comes to see you for outpatient nutritional counseling for osteoporosis.Your client has a history of anorexia nervosa and reports low physical activity.She has recently finished treatment for her anorexia and does not take any medications other than iron for anemia due to her history.
HT: 5'4 WT: 115#
Diet Hx:
B 1 cup plain oatmeal D 1 boneless, skinless chicken breast
1 cup orange juice 1 cup brown rice
¼ cup soybeans
L 2 slices baked ham
1 slice Swiss cheese S 1 cup low-fat chocolate milk
2 slices whole-wheat bread
Lettuce and tomato
1 tsp fat-free mayo
The registered dietitian recommends that she take calcium supplements Which of the following is true?

A)calcium citrate would be the preferred supplement given her history
B)calcium carbonate should be taken with her iron supplement
C)calcium citrate interferes with iron supplements
D)calcium carbonate is more expensive

Question 29

Which joint is the most commonly affected by gout?

A)ankle
B)great toe
C)hip
D)knee

Question 30

Case Study Multiple Choice
You have a 35 yo F client who comes to see you for outpatient nutritional counseling for osteoporosis.Your client has a history of anorexia nervosa and reports low physical activity.She has recently finished treatment for her anorexia and does not take any medications other than iron for anemia due to her history.
HT: 5'4 WT: 115#
Diet Hx:
B 1 cup plain oatmeal D 1 boneless, skinless chicken breast
1 cup orange juice 1 cup brown rice
¼ cup soybeans
L 2 slices baked ham
1 slice Swiss cheese S 1 cup low-fat chocolate milk
2 slices whole-wheat bread
Lettuce and tomato
1 tsp fat-free mayo
How much supplemental calcium will the registered dietitian recommend for her?

A)500 mg once a day
B)500 mg twice a day
C)1000 mg once a day
D)1000 mg twice a day

Question 31

KL is a 70 yo African American F living in a long-term care facility in upstate New York.She has a history of RA, which was well controlled until recently.She reports taking calcium supplements.She presents to the hospital with a hip fracture following a fall.
The above medication may also cause _____, which may require nutrition intervention

A)weight loss
B)decreased appetite
C)increased thirst
D)sodium retention

Question 32

Case Study Multiple Choice
You have a 35 yo F client who comes to see you for outpatient nutritional counseling for osteoporosis.Your client has a history of anorexia nervosa and reports low physical activity.She has recently finished treatment for her anorexia and does not take any medications other than iron for anemia due to her history.
HT: 5'4 WT: 115#
Diet Hx:
B 1 cup plain oatmeal D 1 boneless, skinless chicken breast
1 cup orange juice 1 cup brown rice
¼ cup soybeans
L 2 slices baked ham
1 slice Swiss cheese S 1 cup low-fat chocolate milk
2 slices whole-wheat bread
Lettuce and tomato
1 tsp fat-free mayo
Which of the following will affect her calcium intake?

A)low acidity in the stomach
B)development of lactose intolerance
C)her anemia
D)supplement use

Question 33

Treatment of gout includes all of the following except:

A)NSAIDs.
B)glucocorticoids.
C)allopurinol.
D)glucosamine/chondroitin.

Question 34

KL is a 70 yo African American F living in a long-term care facility in upstate New York.She has a history of RA, which was well controlled until recently.She reports taking calcium supplements.She presents to the hospital with a hip fracture following a fall.
The registered dietitian discusses some additional research that may have potential in reducing symptoms of RA Which of the following might she suggest that KL remove from her diet?

A)antioxidants
B)gluten
C)fish
D)phytates

Question 35

KL is a 70 yo African American F living in a long-term care facility in upstate New York.She has a history of RA, which was well controlled until recently.She reports taking calcium supplements.She presents to the hospital with a hip fracture following a fall.
Which of the following is the likely cause of her fracture?

A)low calcium intake
B)gender
C)history of RA
D)low vitamin D status

Question 36

Which of the following is a chronic musculoskeletal disorder characterized by widespread muscle pain, joint stiffness, cognitive problems, and tender points?

A)Systemic lupus erythematosus
B)Multiple sclerosis
C)Osteoarthritis
D)Fibromyalgia

Question 37

You have just diagnosed an individual with gout; you tell this patient that she/he should avoid purine-rich foods Therefore, you recommend an avoidance of all of the following except _____

A)nuts
B)anchovies
C)chicken or beef liver
D)sardines