wayground logo

Free Printable Worksheets

Font size

S
M
L
XL
Worksheets

osteoporosis

Total questions: 130

Worksheet time: 1hrs 7mins

Name
Class
Date
1.

Which medication is tamoxifen?

a)
b)
c)
d)
2.

Which medication is raloxifene?

a)
b)
c)
d)
3.

Which medication is Cinacalcet?

a)
b)
c)
d)
4.

Which medication is Zoledronic acid (Zometa)?

a)
b)
c)
d)
5.

calcitonin's MOA is:

a)

Increases the availability of calcium for building up bone and inhibits bone resorption

b)

Inhibit bone resorption, but do not induce bone formation

c)

Inhibits RANK Ligand, ultimately leading to ↓ bone resorption

d)

Stimulate bone formation, inhibit bone resorption

6.

Selective estrogen receptor modulators (SERMs) MOA is:

a)

Increases the availability of calcium for building up bone and inhibits bone resorption

b)

Inhibit bone resorption, but do not induce bone formation

c)

Inhibits RANK Ligand, ultimately leading to ↓ bone resorption

d)

Stimulate bone formation, inhibit bone resorption

7.

bisphosphonates MOA is:

a)

Increases the availability of calcium for building up bone and inhibits bone resorption

b)

Inhibit bone resorption, but do not induce bone formation

c)

Inhibits RANK Ligand, ultimately leading to ↓ bone resorption

d)

Stimulate bone formation, inhibit bone resorption

8.
RANK ligand inhibitor (monoclonal antibody) MOA is:
a)
Increases the availability of calcium for building up bone and inhibits bone resorption
b)
Inhibit bone resorption, but do not induce bone formation
c)
Inhibit bone resorption, but do not induce bone formation
d)
Inhibits RANK Ligand, ultimately leading to ↓ bone resorption
e)
Stimulate bone formation, inhibit bone resorption
9.
parathyroid hormones (peptide hormones) MOA is:
a)
Increases the availability of calcium for building up bone and inhibits bone resorption
b)
Inhibit bone resorption, but do not induce bone formation
c)
Inhibit bone resorption, but do not induce bone formation
d)
Inhibits RANK Ligand, ultimately leading to ↓ bone resorption
e)
Stimulate bone formation, inhibit bone resorption
10.
Sclerostin inhibitor (Monoclonal antibody) MOA is:
a)
Increase bone formation, inhibit bone resorption
b)
nonhormonal bone forming agent
c)
Inhibit bone resorption, but do not induce bone formation
d)
Inhibits RANK Ligand, ultimately leading to ↓ bone resorption
e)
Stimulate bone formation, inhibit bone resorption
11.
Inorganic salts MOA is:
a)
Increase bone formation, inhibit bone resorption
b)
nonhormonal bone forming agent
c)
Inhibit bone resorption, but do not induce bone formation
d)
Inhibits RANK Ligand, ultimately leading to ↓ bone resorption
e)
Stimulate bone formation, inhibit bone resorption
12.
raloxifene class is:
a)
selective estrogen receptor modulator (SERMs)
b)
bisphosphonates
c)
RANK Ligand Inhibitor
d)
Parathyroid hormones
13.
alendronate / ibandronate class is:
a)
selective estrogen receptor modulator (SERMs)
b)
bisphosphonates
c)
RANK Ligand Inhibitor
d)
Parathyroid hormones
14.
zoledronic acid class is:
a)
selective estrogen receptor modulator (SERMs)
b)
bisphosphonates
c)
RANK Ligand Inhibitor
d)
Parathyroid hormones
15.
denosumab (prolia) class is:
a)
selective estrogen receptor modulator (SERMs)
b)
bisphosphonates
c)
RANK Ligand Inhibitor
d)
Parathyroid hormones
16.
teriparatide class is:
a)
selective estrogen receptor modulator (SERMs)
b)
bisphosphonates
c)
RANK Ligand Inhibitor
d)
Parathyroid hormones
17.
romosozumab class is:
a)
sclerostin inhibitor (monoclonal antibody)
b)
bisphosphonates
c)
RANK Ligand Inhibitor
d)
Parathyroid hormones
18.
calcitonin and parathyroid hormone belong to peptide chemical classes
a)
true
b)
false
19.
SERMs are very hydrophilic
a)
true
b)
false
20.
which generation of bisphosphonates are non-nitrogen containing ?
a)
first generation
b)
second generation
c)
third generation
21.
which generation of bisphosphonates are nitrogen containing, typically having a primary amine functionality?
a)
first generation
b)
second generation
c)
third generation
22.
which generation of bisphosphonates are nitrogen containing, typically having a cyclic amine or nitrogen containing heterocyclic motif?
a)
first generation
b)
second generation
c)
third generation
23.
which medication inhibits sclerosin, a regulatory factor in bone metabolism and growth?
a)
romosozumab
b)
calcium salts
c)
abalopratide
d)
denosumanb
24.
which medication is a triphenylethylene derivative?
a)
tamoxifen
b)
raloxifene
c)
alendronate
d)
denosumab
25.
which medication is a benzothiophene derivative?
a)
tamoxifen
b)
raloxifene
c)
alendronate
d)
denosumab
26.
which medication is a Phenylalkyl amine derivative?
a)
cinacalcet
b)
raloxifene
c)
alendronate
d)
denosumab
27.
bisphosphonates are very hydrophilic
a)
true
b)
false
28.
which of the following medication is first line treatment for osteoporosis?
a)
alendronate
b)
risendronate
c)
ibandronate
d)
zoledronic acid
29.
which of the following is NOT a first line treatment for osteoporosis due to lack of evidence on reduced hip and vertebral fracture?
a)
alendronate
b)
risendronate
c)
ibandronate
d)
zoledronic acid
30.
which of the following medication is not recommended / last line and is only used for women?
a)
alendronate
b)
calcitonin
c)
ibandronate
d)
zoledronic acid
e)
denusomab
31.
which of the following laboratory test / tool is the gold standard for diagnosing osteoporosis?
a)
fracture risk assessment tool (FRAX)
b)
central dual energy X-ray absorptiometry
c)
fragility fraccture
d)
bone mineral density testing
32.
which of the following test estimates fracture risk at 10 yers with or without DXA?
a)
fracture risk assessment tool (FRAX)
b)
central dual energy X-ray absorptiometry
c)
fragility fraccture
d)
bone mineral density testing
33.
which of the following bisphosphonates is indicated for postmenopausal, male, and glucocorticoid induced osteoporosis?
a)
alendronate
b)
risendronate
c)
zoledronic acid
d)
ibandronate
34.
which of the following bisphosphonates is indicated only for postmenopausal osteoporosis?
a)
alendronate
b)
risendronate
c)
zoledronic acid
d)
ibandronate
35.
which of the following bisphosphonates should be avoided if CrCl <35?
a)
alendronate
b)
risendronate
c)
zoledronic acid
d)
ibandronate
36.
which of the following medications is approved for the treatment of glucocorticoid induced osteoporosis?
a)
teriparatide
b)
abaloparatide
c)
denosumab
d)
ibandronate
37.
which of the following medications is approved for males with osteoporosis?
a)
teriparatide
b)
abaloparatide
c)
denosumab
d)
ibandronate
38.
which of the following medications used to treat osteoporosis has a BBW of osteosarcoma?
a)
teriparatide
b)
abaloparatide
c)
denosumab
d)
bazedoxifene / estrogen
e)
romosozumab
39.
for postmenopausal osteoporosis with very high risk / prior fractures, which of the following medication is first line?
a)
teriparatide
b)
abaloparatide
c)
denosumab
d)
bazedoxifene / estrogen
e)
romosozumab
40.
for postmenopausal osteoporosis with very high risk / prior fractures, which of the following medication is first line?
a)
alendronate
b)
risendronate
c)
zoledronic acid
d)
ibandronate
41.
which of the following diagnostic tools for osteoporosis is used for postmenopausal women and men over 50 who are treatment naive?
a)
fracture risk assessment tool (FRAX)
b)
central dual energy X-ray absorptiometry
c)
fragility fraccture
d)
bone mineral density testing
42.
for patient's with a high risk for fracture, how long should htey consider to continue alendronate/risendronate therapy?
a)
10 years
b)
6 years
c)
5 years
d)
3 years
43.
for patient's with a high risk for fracture, how long should htey consider to continue zoledronic acid therapy?
a)
10 years
b)
6 years
c)
5 years
d)
3 years
44.
a patient taking alendronate has taken a drug holiday after 5 years of starting therapy. when should they consider reiniating their therapy?
a)
1-2 years
b)
1 year
c)
2 years
d)
2-3 years
e)
3 years
45.
a patient taking risendronate has taken a drug holiday after 5 years of starting therapy. when should they consider reiniating their therapy?
a)
1-2 years
b)
1 year
c)
2 years
d)
2-3 years
e)
3 years
46.
a patient taking zoledronic acid has taken a drug holiday after 5 years of starting therapy. when should they consider reiniating their therapy?
a)
1-2 years
b)
1 year
c)
2 years
d)
2-3 years
e)
3 years
47.
patient's should consider a bisphosphonate drug holiday due to serious adverse effects such as atypical femoral fracture and osteonecrosis of the jaw
a)
true
b)
false
48.
which of the following medications is used to increase bone nass in men receiving androgen-depriving therapy and women receiving adjuvant aromatase inhibitor therapy?
a)
teriparatide
b)
abaloparatide
c)
denosumab
d)
bazedoxifene / estrogen
e)
romosozumab
49.
Which of the following meds do not have to be renally dose adjusted?
a)
ibandronate
b)
risendronate
c)
alendronate
d)
denosumab
50.
which of the following medications should be considered for those with very low bone density?
a)
teriparatide
b)
abaloparatide
c)
denosumab
d)
bazedoxifene / estrogen
e)
romosozumab
51.
which medications should not be used for longer than 2 years due to an increased risk of osteosarcoma?
a)
teriparatide
b)
abaloparatide
c)
denosumab
d)
bazedoxifene / estrogen
e)
romosozumab
52.
which medication used to treat osteoporosis effect is lost upon discontinuation?
a)
teriparatide
b)
raloxifene
c)
denosumab
d)
bazedoxifene / estrogen
e)
romosozumab
53.
AO is a 63-year-old female with a T score of – 3.4 and a FRAX probability of 25%. With no history of fractures. Crcl : 66 ml/min. Which of the following would be an appropriate treatment option?
a)
alendronate
b)
teriparatide
c)
abaloparatide
d)
romosozumab
54.
AO is a 63-year-old female with a T score of – 3.4 and a FRAX probability of 25%. With a history of hip fracture. Crcl : 66 ml/min, Which of the following would be an appropriate treatment option?
a)
alendronate
b)
teriparatide
c)
denosumab
d)
ibandronate
e)
raloxifene
55.

what is the active form of vitamin D3?

a)

7-dehydrocholesterol

b)

1,25-dihydroxycholecalciferol

c)

cholecalciferol

d)

1,24,25-trihydroxy vitamin D3

e)

25-hydroxycholecaliferol

56.
what is the INactive form of vitamin D3?
a)
7-dehydrocholesterol
b)
1,25-dihydroxycholecalciferol
c)
cholecalciferol
d)
1,24,25-trihydroxy vitamin D3
e)
25-hydroxycholecaliferol
57.
SERMs are very lipophilic this leads to rapid absorption following oral administration, but this series of agents have very low bioavailability due to rapid metabolism and efflux via P‐glycoprotein.<br />
a)
true
b)
false
58.
raloxifene is a derivative of what:
a)
triarylethylene derivative
b)
benzothiophene derivative
c)
Phenylalkyl amine derivative
d)
nitrogen‐containing heterocyclic derivative
59.
tamoxifen is a derivative of what:
a)
triarylethylene derivative
b)
benzothiophene derivative
c)
Phenylalkyl amine derivative
d)
nitrogen‐containing heterocyclic derivative
60.
the P-O-P backbone of bisphosphonates is essential for binding to bone mineral
a)
true
b)
false
61.
the R1 (OH) of bisphosphonates decreases the affinity for bone mineral
a)
true
b)
false
62.
the R2 functionality of bisphosphonates is critical for enhancing antiresorptive potency
a)
true
b)
false
63.
bisphosphonate agents are lipophilic, causing poor absorption in the gut, limited cellular penetration, and low distribution.
a)
true
b)
false
64.
bisphosphonates are not metabolized because of stable P‐C‐P bond.
a)
true
b)
false
65.
cinacalcet is a derivative of what:
a)
triarylethylene derivative
b)
benzothiophene derivative
c)
Phenylalkyl amine derivative
d)
nitrogen‐containing heterocyclic derivative
66.
hypocalcemia results in _____ Na+ permeability into neurons causing nerve depolarization leading to tetany (spotaneous and prolonged muscle contractions)
a)
increased
b)
decreased
67.
magnesium deficiency casues:
a)
HYPOcalcemia
b)
HYPERcalcemia
68.
HYPERcalcemia is caused by
a)
decreased PTH activity
b)
increased PTH activity
69.
which medication causes HYPERcalcemia?
a)
thiazide diuretics
b)
lithium
c)
loop diuretics
d)
chemotherapy drugs (cisplatin, 5-FU)
70.
which medication causes HYPOcalcemia?
a)
thiazide diuretics
b)
lithium
c)
loop diuretics
d)
chemotherapy drugs (cisplatin, 5-FU)
71.
thiazide diuretics increase or inhibit calcium reabsorption in the kidneys?
a)
increase = hypercalcemia
b)
inhibit = hypocalcemia
c)
increase = hypocalcemia
d)
inhibit = hypercalcemia
72.
which diuretic targets the distal tubule of the kidneys, inhibiting the sodium chloride cotransporter ?
a)
hydrochlorothiazide
b)
chlorthiazide
c)
furosemide
d)
bumetanide
e)
ethacrynic acid
73.
which diuretic targets the ascending loop of henle, targeting the sodium potassium transporter?
a)
hydrochlorothiazide
b)
chlorthiazide
c)
furosemide
d)
bumetanide
e)
ethacrynic acid
74.
thiazide diuretics are more likely to cause:
a)
HYPOcalcemia
b)
HYPERcalcemia
75.
loop diuretics are more likely to cause:
a)
HYPOcalcemia
b)
HYPERcalcemia
76.
loop diuretics increase or inhibit calcium reabsorption in the kidneys?
a)
increase = hypercalcemia
b)
inhibit = hypocalcemia
c)
increase = hypocalcemia
d)
inhibit = hypercalcemia
77.
is alkalosis (metabolic or respiratory) more likely to cause HYPERphosphatemia or HYPOphosphatemia?
a)
HYPERphosphatemia
b)
HYPOphosphatemia
78.
what effect does chronic kidney disease (renal failure) have on blood phosphate levels?
a)
HYPERphosphatemia
b)
HYPOphosphatemia
79.
UV light is responsible for which step in the biosynthetic pathway for calcitriol synthesis?
a)
7-dehydrocholesterol --> cholecalciferol (inactive vitamin D)
b)
cholecalciferol (inactive vitamin D) --liver--> 25-hydroxycholecalciferol
c)
25-hydroxycholecalciferol --kidney--> calcitrol
80.
what step is stimulated by PTH?
a)
7-dehydrocholesterol --> cholecalciferol (inactive vitamin D)
b)
cholecalciferol (inactive vitamin D) --liver--> 25-hydroxycholecalciferol
c)
25-hydroxycholecalciferol --kidney--> calcitrol
81.
what step occurs in the liver?
a)
7-dehydrocholesterol --> cholecalciferol (inactive vitamin D)
b)
cholecalciferol (inactive vitamin D) --> 25-hydroxycholecalciferol
c)
25-hydroxycholecalciferol --> calcitrol
82.
what step occurs in the kidneys?
a)
7-dehydrocholesterol --> cholecalciferol (inactive vitamin D)
b)
cholecalciferol (inactive vitamin D) --> 25-hydroxycholecalciferol
c)
25-hydroxycholecalciferol --> calcitrol
83.
what effect does calcitrol have on blood calcium levels?
a)
increased blood calcium
b)
decreased blood calcium
84.
do glucocorticoids stimulate or inhibit calcium from the intestines and kidneys?
a)
strimulate
b)
inhibits
85.
what is the net effect glucocorticoids have on blood calcium levels?
a)
increased blood calcium
b)
decreased blood calcium
86.
what effect dose high blood calcium levels have on PTH release?
a)
decreased PTH activity
b)
increased PTH activity
87.
what effect dose low blood calcium levels have on PTH release?
a)
decreased PTH activity
b)
increased PTH activity
88.
what type of receptor is the vitamin D receptor?
a)
GPCR
b)
ion channel
c)
nuclear receptor
89.
what form of vitamin d is the most active as an agonist at the vitamin d receptor?
a)
cholecalciferol
b)
calcidiol
c)
calcitriol
90.
which medications MOA is to mimic high calcium levels in order to inhibit PTH secretion, thereby promoting bone resorption
a)
cinacalcet
b)
etelcalcetide
c)
abaloparatide
d)
teriparatide
e)
denosumab
91.
which of the following is NOT bone-catabolic?
a)
activated vitamin D (calcitriol)
b)
calcitonin
c)
PTH
d)
RANKL
e)
OPG
92.
which of the following is NOT bone-catabolic?
a)
estradiol
b)
calcitonin
c)
PTH
d)
RANKL
e)
OPG
93.
which medicaton common AE is hypocalcemia?
a)
cinacalcet
b)
etelcalcetide
c)
abaloparatide
d)
teriparatide
e)
denosumab
94.
which medication is a strong CYP2D6 inhibitor?
a)
cinacalcet
b)
etelcalcetide
c)
abaloparatide
d)
teriparatide
e)
denosumab
95.

Based on the SAR of bisphosphonates, which of the following drugs is expected to have most potent antiresorptive activity?

a)
b)
c)
d)
e)
96.

which of the following images is a first generation bisphosphonate?

a)
b)
c)
d)
e)
97.

which of the following images is a second generation bisphosphonate?

a)
b)
c)
d)
e)
98.

which of the following images is a third generation bisphosphonate?

a)
b)
c)
d)
e)
99.

Regarding the structure shown below, which of the following statement is true?

a)

It has benzothiophene moiety

b)

It has mercapto functional group

c)

Phenolic hydroxyl groups is a strong basic group

d)

Under physiological pH 7.4, majority of the molecules will be in ionized form

e)

It has a cyclic secondary amine moiety

100.

which of the following structures has a triarylethylene or triphenylethylene derivative?

a)
b)
c)
d)
101.

which of the following structures has a benzothiophene derivative?

a)
b)
c)
d)
102.

which of the following structures has a Weakly acidic Phenolic hydroxy functionality?

a)
b)
c)
d)
103.

which of the following structures has a piperadine and tertiary amine?

a)
b)
c)
d)
104.

which of the following structures has a Phenylalkyl amine derivative?

a)
b)
c)
d)
105.

which of the following structures has a Naphthalene moiety?

a)
b)
c)
d)
106.

which of the following structures has an indole‐based derivative?

a)
b)
c)
d)
107.

which of the following is NOT a first generation bisphosphonate?

a)

etidronate

b)

clodronate

c)

tiludronate

d)

pamidronate

108.

which of the following is NOT a third generation bisphosphonate?

a)

risendronate

b)

ibandronate

c)

zoledronic acid

d)

alendronte

109.

which of the following is a first generation bisphosphonate?

a)
b)
c)
d)
e)
110.

which of the following is a second generation bisphosphonate?

a)
b)
c)
d)
e)
111.

which of the following is a third generation bisphosphonate?

a)
b)
c)
d)
e)
112.

which of the following is a first generation bisphosphonate?

a)
b)
c)
d)
e)
113.

unlike most bisphosphonates, which drug taken with medications that inhibit gastric acid secretion like H2RA and PPI's actually promote the medication absorption?

a)

alendronate

b)

risendronate

c)

ibandronate

d)

zoledronic acid

114.

calcitonin

a)

inhibits bone resorption

b)

increases bone resorption

c)

inhibits bone formation

d)

increases bone formation

115.

selective estrogen receptor modulators (SERMs)

a)

inhibits bone resorption

b)

increases bone resorption

c)

inhibits bone formation

d)

increases bone formation

116.

bisphosphonates

a)

inhibits bone resorption

b)

increases bone resorption

c)

inhibits bone formation

d)

increases bone formation

117.

RANK ligand inhibitors

a)

inhibits bone resorption

b)

increases bone resorption

c)

inhibits bone formation

d)

increases bone formation

118.

RANK ligand

a)

inhibits bone resorption

b)

increases bone resorption

c)

inhibits bone formation

d)

increases bone formation

119.

parathyroid hormones (PTH)

a)

inhibits bone resorption

b)

increases bone resorption

c)

inhibits bone formation

d)

increases bone formation

120.

teriparatide / abaloparatide

a)

inhibits bone resorption

b)

increases bone resorption

c)

inhibits bone formation

d)

increases bone formation

121.

romosozumab (sclerostin inhibitor)

a)

inhibits bone resorption

b)

increases bone resorption

c)

inhibits bone formation

d)

increases bone formation

122.

parathyroid hormones ________ RANK ligand expression

a)

inhibit

b)

stimulate

123.

Calcitriol (activated Vit D) ________ RANK ligand expression

a)

inhibit

b)

stimulate

124.

OPG

a)

inhibits bone resorption

b)

increases bone resorption

c)

inhibits bone formation

d)

increases bone formation

125.

What steroid hormone STIMULATES OPG expression and inhibits bone resorption?

a)

estrogen

b)

progesterone

c)

parathyroid hormone

d)

cortisol

126.

What steroid hormone INHIBITS OPG expression and favors bone resorption?

a)

estrogen

b)

progesterone

c)

parathyroid hormone

d)

cortisol

127.

how does chronic kidney disease affect parathyroid hormone levels?

a)

increase PTH

b)

decrease PTH

128.

how does chronic kidney disease affect vitamin D (calcitrol) levels ?

a)

increase vitamin D

b)

decrease vitamin D

129.

how does chronic kidney disease affect blood calcium and phosphate levels?

a)

increase calcium & phosphate

b)

decrease calcium & phosphate

130.

how does chronic kidney disease affect bone density?

a)

bone resorption

b)

bone accretion

Similar Resources on Wayground

EMS103 MIDTERM

125 questions

EMS103 MIDTERM

quiz

Worksheet

•

Professional Development