Bone Growth and Hormonal Regulation Quiz
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Questions and Answers

Which hormone stimulates osteoclasts to resorb bone when calcium or phosphorus levels are low?

  • Calcitonin
  • Teriparatide
  • Estrogen
  • Parathyroid hormone (PTH) (correct)
  • What is the role of PTH in facilitating calcium absorption?

  • It stimulates the intestines to absorb more calcium and the kidneys to activate more vitamin D. (correct)
  • It has no role in calcium absorption.
  • It reduces bone resorption stimulated by calcitonin.
  • It increases the secretion of endogenous calcitonin to decrease serum calcium levels.
  • What is the role of estrogens in bone remodeling?

  • They increase the risk for osteoporosis in postmenopausal women.
  • They have no role in bone remodeling.
  • They stimulate osteoclasts to resorb bone.
  • They reduce bone resorption stimulated by PTH. (correct)
  • Which hormone balances the action of PTH by shutting down osteoclastic activity and increasing osteoblastic activity in the presence of hypercalcemia?

    <p>Calcitonin</p> Signup and view all the answers

    Why were all previously marketed calcitonin drugs pulled off the market?

    <p>They were associated with an increased risk of cancer.</p> Signup and view all the answers

    What are teriparatide (Forteo) and abaloparatide (Tymlos)?

    <p>Synthetic injectable PTH analogues derived from recombinant DNA technology.</p> Signup and view all the answers

    Which supplement is recommended to be taken with calcium to improve calcium uptake?

    <p>Vitamin K</p> Signup and view all the answers

    What is the recommended vitamin D level before initiating bisphosphonate therapy?

    <p>Greater than 30 ng/mL</p> Signup and view all the answers

    Which population is now being encouraged to take calcium and vitamin D supplements?

    <p>Community-dwelling postmenopausal women without a fracture history</p> Signup and view all the answers

    What percentage of calcium is typically absorbed from dietary sources?

    <p>10% to 12%</p> Signup and view all the answers

    Which type of patients might prefer calcium citrate over calcium carbonate due to better absorption?

    <p>Patients with high gastric pH</p> Signup and view all the answers

    What is the primary purpose of taking calcium and vitamin D supplements in older adults?

    <p>Prevention of osteoporosis</p> Signup and view all the answers

    Which population should avoid whole milk after the age of 12 months?

    <p><em>Infants</em> after 12 months of age</p> Signup and view all the answers

    What can greatly affect the amount of calcium in the diet and make supplementation mandatory?

    <p><em>Milk allergy</em></p> Signup and view all the answers

    What is the recommended daily maximum dose of vitamin D supplements?

    <p>10,000 IU/d</p> Signup and view all the answers

    Which of the following is considered a first-line therapy for osteoporosis according to the guidelines mentioned in the text?

    <p>Bisphosphonates</p> Signup and view all the answers

    Which of the following combinations is mentioned in the text as having potential additive effects on bone mineral density (BMD)?

    <p>Both A and B</p> Signup and view all the answers

    Which of the following statements is true regarding the combination of teriparatide and denosumab?

    <p>It had a much more positive impact than each used separately, especially on femoral neck and hip density.</p> Signup and view all the answers

    Which of the following statements is true regarding the use of fluoride for bone health?

    <p>Fluoride stimulates bone growth, but the bone may be weaker than naturally developed bone.</p> Signup and view all the answers

    Which of the following statements is true regarding the use of calcium supplements?

    <p>Calcium supplements alone rarely need blood test follow-up.</p> Signup and view all the answers

    Which of the following statements is true regarding the use of vitamin D supplements alone?

    <p>Vitamin D alone is ineffective for osteoporosis treatment or risk reduction.</p> Signup and view all the answers

    Which of the following statements is true regarding the use of Selective Estrogen Receptor Modulators (SERMs) for osteoporosis treatment?

    <p>SERMs are effective in preventing fractures and have less cardiovascular risk than estrogen.</p> Signup and view all the answers

    Which of the following statements is true regarding the use of estrogen for osteoporosis treatment?

    <p>Estrogen is effective in preventing fractures but has cardiovascular and cancer risks.</p> Signup and view all the answers

    Which of the following statements is true regarding the use of alternative agents for bone health?

    <p>Findings from clinical trials on alternative agents such as phytoestrogens and isoflavones have been inconsistent in their support.</p> Signup and view all the answers

    Which medication has been linked with atypical femur fractures similar to bisphosphonates?

    <p>Denosumab</p> Signup and view all the answers

    What impact does inadequate vitamin D have on calcium absorption and PTH levels according to the text?

    <p>Decreases calcium absorption and increases PTH levels</p> Signup and view all the answers

    Why is combination treatment with denosumab and immunosuppressants, steroids, and biologics not recommended?

    <p>Due to possible sepsis risk</p> Signup and view all the answers

    What is the upper limit of daily intake for vitamin D supplements to avoid hypervitaminosis?

    <p>4,000 IU/day</p> Signup and view all the answers

    Which form of vitamin D is more biologically active?

    <p>D1,25-dihydroxy</p> Signup and view all the answers

    What is the serum level range for optimal bone health in terms of vitamin D?

    <p>$30$ to $50$ ng/mL</p> Signup and view all the answers

    What can excess serum calcium deposits in soft, vascular plaque lead to?

    <p>$Less$ ability to regress in plaque</p> Signup and view all the answers

    $100$ to $250$ mg of calcium are absorbed from the gut out of how much calcium consumed daily?

    <p>$500$ to $750$ mg</p> Signup and view all the answers

    $D25$-dihydroxy, a form of vitamin D, is converted into which form in the liver?

    <p>$D1,25$-dihydroxy</p> Signup and view all the answers

    What is the concern associated with taking calcium supplements without vitamin D?

    <p>Increased fracture rates</p> Signup and view all the answers

    What is the primary mechanism of action for the drugs described in the text?

    <p>Stimulating bone formation, especially in the axial skeleton</p> Signup and view all the answers

    What is the recommended duration of treatment with these drugs?

    <p>2 years</p> Signup and view all the answers

    Which of the following patient populations is recommended to use these drugs according to the text?

    <p>Post-menopausal women at high risk for fracture</p> Signup and view all the answers

    What is the main reason the text suggests for combining these drugs with IV bisphosphonate therapy or RANKL medications?

    <p>To have an additive impact on bone mineral density</p> Signup and view all the answers

    Which of the following is a potential side effect associated with the use of these drugs described in the text?

    <p>Orthostatic hypotension</p> Signup and view all the answers

    What is the main reason these drugs are considered third-line therapy for osteoporosis?

    <p>They have very limited indications</p> Signup and view all the answers

    What is the main difference in storage requirements between teriparatide and abaloparatide described in the text?

    <p>Teriparatide requires refrigeration for 28 days, while abaloparatide does not</p> Signup and view all the answers

    What is the primary role of denosumab (Prolia) as described in the text?

    <p>To inhibit osteoclast survival and function</p> Signup and view all the answers

    What is the main concern associated with the use of denosumab (Prolia)?

    <p>Increased risk of osteonecrosis of the jaw</p> Signup and view all the answers

    What is the main benefit of combining teriparatide with oral bisphosphonates as described in the text?

    <p>It does not provide any additional benefit</p> Signup and view all the answers

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