True or False

The proximal femur (hip) is the most common fracture site for osteoporosis related fractures.

False.

Vertebral fractures are the most common fracture site.

SERMS (selective estrogen receptor modulators), specifically the drug raloxifene (Evista), works like estrogen on the bones. Which statement is true?

a) SERMS do not affect BMD

b) No risks are associated with the use of SERMS

c) SERMS mode of action is bone formation agent

d) SERMS are approved for both prevention and treatment of osteoporosis

d) SERMS are approved for both prevention and treatment of osteoporosis

This drug is approved for both prevention and treatment. It has been proven to increase BMD, decrease vertebral fractures. Its mode of action is antiresorption and the risks are similar to estrogen therapy.

Osteoporosis is a public health concern because ………… Americans are affected by it.

a) 26 Million

b) 19 Million

c) 1 Billion

d) 54 Million

d) 54 Million

54 million Americans are affected by osteoporosis.

True or False

Some studies suggest 1 out of 4 men will suffer from broken bones related to osteoporosis.

True

Osteoporosis affects men as well as women and 1 out of 4 men may suffer from fractures caused by osteoporosis.

Which of the following are potential risks of Bisphosphonates?

a) Migraine headaches

b) There are no documented risks

c) GI irritation or possible bleeding

d) Drowsiness

c) GI irritation or possible bleeding

GI irritation or bleeding is a risk of Bisphosphonates. Dosing options are typically weekly or monthly and patients are usually instructed to remain in an upright position for 30 minuted after taking the medication.

Fall prevention should always be part of clinical management of patients with low bone mass including:

a) Grab bars and mats in the bathroom

b) Eliminate scatter rugs in the home

c) Night lights and handrails

d) All the above

d) All the above

All the choices are proper fall prevention techniques.

Serious consequences are attributed to hip fractures including:

a) Surgery is generally required

b) Approximately 50% of patients with hip fractures cannot walk independently 1 year later.

c) 60% of patients with hip fractures cannot resume general daily living activities.

d) All of the above

d) All of the above

Correct answer is D, all of the above, are consequences of hip fractures. Mortality rates also increase for these patients.

True or False

Disease prevention includes proper nutrition, adequate calcium and vitamin D intake, weight bearing exercise and healthy lifestyle choices.

True

This statement is true. These are all steps a person can take to help prevent bone loss.

When is pharmacologic intervention appropriate?

a) In postmenopausal women and men over the age of 50 with T-Scores -2.5 or below

b) Patients with no history of fracture but T-Scores that indicate low bone mass

c) Patients with a T-Score of -1.0 or below with a FRAX 10 year probability of hip fracture greater than or equal to 3% or FRAX 10 year probability of any major osteoporotic fracture great than or equal to 20% (US-adapted WHO algorithm)

d) A and C only

e) A, B and C

d) A and C only

Patients with no history of fracture and T-Scores above -2.5 may be managed clinically without drug therapy.

Type 2 primary osteoporosis occurs:

a) Due to estrogen decrease with menopause

b) Late in life, generally after age 70 and is also known as senile osteoporosis

c) as a side effect of certain medicines

d) in premenopausal women

b) Late in life, generally after age 70 and is also known as senile osteoporosis

Type 2 (senile) primary osteoporosis occurs late in life and is age related. Usually onsets after age 70.

True or False

Osteoporosis is termed "the silent disease" because symptoms seldom present prior to fracture, height loss or stooped posture.

True

There are typically no early symptoms for osteoporosis.

Adequate calcium and vitamin D is important in preventing or managing osteoporosis. What is the recommended daily intake?

a) 800 mg calcium and 1600 IU vitamin D per day

b) Only what can be eaten in a normal diet each day

c) 400-800 IU vitamin D and 1200-1500 mg calcium per day

d) 2500 mg calcium and 2500 IU vitamin D per day

c) 400-800 IU vitamin D and 1200-1500 mg calcium per day

1200-1500 mg of calcium and 400-800 IU vitamin D is the recommended amount each day. While meeting these requirements through daily diet is optimal, it is often not achievable. Supplements can help insure adequate intake.

True or False

Bisphosphonates have a proven track record of increased BMD, but no decrease in the number of fractures in the patients undergoing treatment.

False

Bisphosphonates have a proven track record of both increased BMD and fewer fractures in patients taking this therapy.

Which statement is false? Kyphosis, a symptom of osteoporosis,

a) is one of the first symptoms a patient may experience.

b) is a byproduct of vertebral fractures.

c) can cause compressed organs.

d) is often associated with advanced disease process.

a) is one of the first symptoms a patient may experience.

Kyphosis, when present, is typically an indication that the disease is very advanced. Often there are no symptoms.

Primary osteoporosis is

a) Common and age related

b) Divided into two types

c) Due to Endocrine disorders

d) All of the above

e) A and B only

e) A and B only

Endocrine disorders contribute to secondary osteoporosis, not primary osteoporosis.

Which of the following lifestyle choices would not be considered a risk factor for osteoporosis?

a) Smoking

b) Frequent travel by airplane

c) Alcohol abuse

d) Sedentary lifestyle

b) Frequent travel by airplane

Smoking, alcohol abuse and living a sedentary lifestyle are all risk factors, however, there is no evidence that air travel is a risk factor for osteoporosis.

What are the risk factors for osteoporosis?

a) Aging for both men and women

b) Estrogen or testosterone deficiency

c) malabsorption

d) All the above

d) All the above

The correct answer is all the above. All three choices are risk factors for osteoporosis, along with Cushing's disease, lifestyle choices such as smoking, hyperthyroidism, anticonvulsants, lithium and long term use of steroids.

Which of the following treatment drugs for osteoporosis are included in the Bisphosphonates family?®

a) Quick release risedronate (Actonal)

b) Estrogen

c) Prolia

d) A and C only

e) None of the above

a) Quick release risedronate (Actonal)

Actonal is included in the Bisphosphonate class of therapy drugs. Estrogen is approved for prevention only and Prolia is a Denosumab.

True or False

The definition of osteoporosis states that a fracture must be present before a diagnosis can be made.

False

The correct answer is false. After the 1991 and 1993 conferences held by the NOF and other global organizations the stipulation of fracture was dropped from the definition.

True or False

Estrogen is approved by the FDA for the prevention of osteoporosis.

True

The FDA approved estrogen for the prevention of osteoporosis. Estrogen is not classified as a treatment option.