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Osteoporosis/Rheumatology

Total questions: 21

Worksheet time: 11mins

Name
Class
Date
1.

Which promotes net bone resorption?

a)

acidosis

b)

estrogen

c)

growth hormone

d)

testosterone

2.

Which is thought to first occur in osteoarthritis?

a)

bony destruction

b)

exogenous cytokine release

c)

swelling of cartilage

d)

synovial destruction

3.

A patient presents to you with low-back pain, which she attributes to her being diagnosed with osteoporosis. Osteoporosis is usually not visible on conventional radiographs until at least ____% of bone mineral has been lost.

a)

10-15

b)

15-20

c)

25-30

d)

35-40

e)

40-45

4.

kyphotic posture may improve with:

a)

abdominal strengthening exercise

b)

back extensor strengthening exercises

c)

spinal flexion exercises

d)

use of a williams back brace

5.

a biochemical marker of bone formation is:

a)

24 hour urinary calcium excretion

b)

hydroxyproline in urine

c)

pyridinium cross-links in urine

d)

serum alkaline phosphatase

6.

Which epitope is associated with rheumatoid arthritis?

a)

HLA-DR2

b)

HLA-DR4

c)

HLA-DR6

d)

HLA-B27

7.

 A 55-year-old male comes to your office for pain and stiffness.  He reports he has been having difficulty with back and neck range of motion and difficulty swallowing.  You order an x-ray and see calcifications in the ligaments at their insertion.  You diagnose Diffuse Idiopathic Skeletal Hyperostosis (DISH).   This condition preferentially affects the:

a)

Cervical Spine

b)

Thoracic Spine

c)

Lumbar Spine

d)

Pelvis

8.

Pseudogout may be associated with

a)

amyloidosis

b)

hyperthyroidism

c)

hypocalcemia

d)

characteristic rash

9.

What is the average amount of time between gout attacks?

a)

1 week

b)

6 months

c)

11 months

d)

24 months

10.

Bouchard's nodes are located at the:

a)

DIPs

b)

PIPs

c)

MCPs

d)

Wrists

11.

which of the following rheumatic diseases produces the most disability in the general population

a)

fibromyalgia

b)

rheumatoid arthritis

c)

osteoarthritis

d)

tendonitis

12.

which image technique is most sensitive in detecting sacroiliitis?

a)

conventional radiography

b)

CT scan

c)

bone scan

d)

MRI

13.

all of the following disease-modifying antirheumatic drugs (DMARDS) have been approved for use in patients with rheumatoid arthritis and ankylosing spondylitis except:

a)

tumor necrosis factor antagonists

b)

methotrexate

c)

rituximab

d)

sulfasalazine

14.

all of the following statements regarding seronegative spondyloarthropathies are true except:

a)

psoriatic arthritis can affect primarily the spine or small hand joints

b)

enthesitis is an inflammation of tendon insertions into bone

c)

they include ankylosing spondylitis, reactive arthritis, and reiter syndrome

d)

exercise is contraindicated when the disease affects the lumbar spine

15.

72-year-old female  comes to your clinic for bilateral knee pain.  She reports it gets worse with activity and usually is worse in the afternoon compared to the morning.  She points to the medial knee bilaterally for the maximal point of tenderness.  On exam you notice crepitus and confirm her tenderness.  All other provocative maneuvers of the knee are normal.  Which of the following is not a radiographic finding of this condition?

a)

loose bodies

b)

osseous cysts

c)

osteopenia

d)

subchondral sclerosis

16.

Podagra is observed in all of these except:

a)

gout

b)

reactive arthritis

c)

sarcoidosis

d)

pesudogout

17.

How would you best describe typical radiographic findings of hip osteoarthritis?

a)

Diffuse joint space narrowing

b)

Inferomedial joint space narrowing

c)

Medial joint space narrowing

d)

Superolateral joint space narrowing

18.

A 48-year-old female was recently diagnosed with osteoporosis.  She is trying to do everything she can to prevent this from progressing.  How much calcium should she be taking daily?

a)

500-1000mg

b)

1200-1500mg

c)

1500-2000mg

d)

2000mg-2500mg

19.

How much vitamin D should a patient with osteoporosis take daily?

a)

200-400 IU

b)

400-800 IU

c)

800-1000 IU

d)

1000-1200 IU

20.

Which type of orthotic can be prescribed to decrease pain in a patient with a stable osteoporotic vertebral body fracture?

a)

CASH Brace

b)

Jewett Brace

c)

Nonrigid Brace

d)

Rigid Brace

21.

Chest expansion less than how many cm is associated with an increased risk of restrictive lung disease in ankylosing spondylitis?

a)

7-8cm

b)

9-10cm

c)

15-16cm

d)

20-21cm