Sclerostin Inhibitors and Bone Formation Quiz
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Questions and Answers

During what process do bones increase in size and shift in space?

  • Osteopenia
  • Osteoporosis
  • Remodeling
  • Modeling (correct)

    • At what age range is skeletal mass typically maximal?

  • 20-25 years
  • 35-40 years
  • 30-35 years
  • 25-30 years (correct)

    • In which gender does bone mass decline start earlier?

  • Women, after age 50 years
  • Men, after age 40 years
  • Women, after age 40 years (correct)
  • Men, after age 50 years

    • What is the definition of osteoporosis provided in the text?

    <p>Having a bone density 2.5 standard deviations below the average adult peak bone mass</p> Signup and view all the answers

    According to the passage, how often is most of the adult skeleton replaced?

    <p>Every 10 years</p> Signup and view all the answers

    Which group is mentioned as being at high risk for osteopenia in peri-menopausal women?

    <p>White and Asian women in industrial societies</p> Signup and view all the answers

    What is the estimated direct cost of caring for patients with osteoporotic fractures in the United States each year?

    <p>Up to $20 billion</p> Signup and view all the answers

    What percentage of fragility fractures occur after age 65 years?

    <p>Over 75%</p> Signup and view all the answers

    What is the risk of death from complications associated with a hip fracture within the first year of the incident?

    <p>Approaches 25%</p> Signup and view all the answers

    What percentage of hip fracture patients have lifelong mobility issues, with 25% requiring admission to long-term care?

    <p>Over 50%</p> Signup and view all the answers

    Which of the following is NOT a risk factor for bone loss?

    <p>High protein intake</p> Signup and view all the answers

    What percentage of osteoporosis-related fractures in the United States are in women?

    <p>80%</p> Signup and view all the answers

    What is the recommended approach to reducing falls risk in older adults with diabetes?

    <p>Avoiding tight glucose control targets that might induce hypoglycemia</p> Signup and view all the answers

    What is the relationship between insulin resistance and bone mass development in young patients?

    <p>Insulin resistance is associated with decreased bone mass development in earlier teen years</p> Signup and view all the answers

    What is the relationship between abdominal obesity and bone health?

    <p>Abdominal obesity is a negative factor for bone health</p> Signup and view all the answers

    Which ethnic group has the highest hip fracture rates?

    <p>White populations</p> Signup and view all the answers

    Which bisphosphonate is the most potent inhibitor of bone resorption?

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

    Which bisphosphonate is known to induce osteoclast apoptosis?

    <p>Zoledronic acid</p> Signup and view all the answers

    Which bisphosphonate has been shown to reduce nonvertebral fractures?

    <p>Alendronate, risedronate, and zoledronic acid</p> Signup and view all the answers

    Which bisphosphonate has the shortest terminal half-life in bone?

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

    Which bisphosphonate is not recommended for use during breastfeeding?

    <p>Zoledronic acid</p> Signup and view all the answers

    Which bisphosphonate has been shown to increase bone mineral density in children with low bone density due to malabsorption syndromes?

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

    Which bisphosphonate is available only for parenteral use?

    <p>Pamidronate and zoledronic acid</p> Signup and view all the answers

    Which bisphosphonate reduces both bone resorption and bone formation?

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

    Which bisphosphonate has the longest terminal half-life in bone?

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

    Which bisphosphonate is used to prevent heterotopic ossifications or soft tissue calcifications in children?

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

    Which of the following bisphosphonate drugs is typically reserved for monthly cancer metastasis prevention and treatment?

    <p>The 4 mg dosing of zoledronic acid</p> Signup and view all the answers

    Which statement is true about the dosing schedule for the intravenous (IV) administration of ibandronate?

    <p>3 mg given over 30 seconds and repeated every 3 months</p> Signup and view all the answers

    What is the typical dosage schedule for etidronate in the treatment of post-menopausal osteoporosis?

    <p>400 mg daily for 14 days, followed by 76 days of elemental calcium, 500 mg daily</p> Signup and view all the answers

    According to the passage, what is the lowest cost bisphosphonate drug?

    <p>Generic alendronate tablets</p> Signup and view all the answers

    Which of the following statements about etidronate is true, according to the passage?

    <p>Its labeled use is for treatment of Paget disease, but it has off-label uses</p> Signup and view all the answers

    What is the primary clinical use of bone remodeling drugs shifting towards?

    <p>Patients with the highest risk of fracture development</p> Signup and view all the answers

    What is the dosage schedule mentioned in the passage for zoledronic acid, an IV osteoporosis treatment and fracture prevention medication?

    <p>5 mg, taken yearly</p> Signup and view all the answers

    What condition is associated with altering the balance between bone resorption and formation?

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

    What percentage of skeletal mass will be lost in 20 years if bone resorption exceeds formation by 2% per year?

    <p>40%</p> Signup and view all the answers

    Which tool estimates the 10-year probability of major bone fractures at the hip, wrist, and shoulder?

    <p>FRAX scores</p> Signup and view all the answers

    What is the recommended interval for screenings according to the U.S. Preventive Services Task Force in 2017?

    <p>5 years apart</p> Signup and view all the answers

    How does the FRAX score alone estimate the risk compared to other evaluation tools for osteoporosis?

    <p>Underestimates the risk</p> Signup and view all the answers

    At what age do women have a 23% chance of hip fracture according to Black et al (2017)?

    <p>Over 80 years</p> Signup and view all the answers

    Which statement is true regarding the metabolism of bisphosphonates?

    <p>There is no evidence that they are systemically metabolized.</p> Signup and view all the answers

    How is the drug that is not distributed to bone typically eliminated from the body?

    <p>Through urinary excretion</p> Signup and view all the answers

    For patients with moderate to severe renal impairment, what is the recommendation regarding the use of bisphosphonates?

    <p>They are not recommended for these patients.</p> Signup and view all the answers

    Which of the following is an absolute contraindication for the use of bisphosphonates, according to the text?

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

    What is recommended for patients with gastrointestinal disorders when using bisphosphonates?

    <p>Cautious use is recommended.</p> Signup and view all the answers

    Which of the following statements is true regarding the risk of severe adverse reactions in the esophagus when taking bisphosphonates?

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

    What is the potential solution marketed for addressing the issues related to adverse reactions in the esophagus?

    <p>The effervescent alendronate (Binosto)</p> Signup and view all the answers

    What is the reason for withholding etidronate from patients with enterocolitis, according to the text?

    <p>They sometimes get diarrhea, particularly at high doses.</p> Signup and view all the answers

    What is the risk associated with giving high doses of etidronate or prolonged therapy (longer than 6 months) to patients with Paget disease?

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

    What is the rare form of fracture that is under scrutiny for patients without Paget disease who take bisphosphonates, according to the text?

    <p>Subtrochanteric femur fracture</p> Signup and view all the answers

    Which of the following is a risk factor for osteoporosis that is common among African American women?

    <p>Lower prevalence of lactose intolerance</p> Signup and view all the answers

    According to the passage, which of the following is a reason why Hispanic women have an increased risk of osteoporosis?

    <p>They have a higher rate of diabetes compared to white women</p> Signup and view all the answers

    What is the primary mechanism by which bisphosphonates help prevent osteoporosis?

    <p>They inhibit the formation and activity of osteoclasts</p> Signup and view all the answers

    Which of the following is a risk factor for osteoporosis that is common among Asian women?

    <p>Higher rate of lactose intolerance</p> Signup and view all the answers

    Which of the following is NOT a risk factor for osteoporosis in men, as described in the passage?

    <p>Having a body weight greater than 70 kg</p> Signup and view all the answers

    What is the role of RANKL in the bone remodeling process?

    <p>RANKL facilitates the formation of osteoclasts</p> Signup and view all the answers

    Which of the following medication groups can be used to support bone health, according to the passage?

    <p>Estrogens, SERMs, and parathyroid hormone agents</p> Signup and view all the answers

    What is the primary role of osteoblasts in the bone remodeling cycle?

    <p>Osteoblasts line up and form new bone in the resorption pits</p> Signup and view all the answers

    Which of the following is a common risk factor for osteoporosis among both African American and Asian women?

    <p>Lower calcium intake due to lactose intolerance</p> Signup and view all the answers

    What is the main finding regarding women over 80 years old who took bone medications for more than 10 years?

    <p>They have a greater risk of fracture compared to young patients.</p> Signup and view all the answers

    What is the impact of taking histamine-2 blocking agents with alendronate?

    <p>The impact of histamine-2 blocking agents on alendronate bioavailability is unknown.</p> Signup and view all the answers

    What is the relationship between bisphosphonate use and the risk of GI bleeding?

    <p>The risk of GI bleeding is increased when aspirin and NSAIDs are taken concomitantly with bisphosphonates.</p> Signup and view all the answers

    What is the relationship between concurrent use of bisphosphonates and other bone-building drugs like estrogens and SERMs?

    <p>Concurrent use has a slight additive effect on bone density, but the impact on bone strength and fracture reduction is unknown.</p> Signup and view all the answers

    Which of the following bisphosphonates has the best evidence for reducing hip fractures?

    <p>Zoledronic acid</p> Signup and view all the answers

    What is the recommended initial dose of alendronate for the prevention of bone loss?

    <p>5 mg/day or 35 mg/week</p> Signup and view all the answers

    What is the recommended treatment for patients taking more than 7.5 mg of prednisone or its equivalent for more than 3 weeks?

    <p>Alendronate or risedronate should be prescribed.</p> Signup and view all the answers

    What is the main concern regarding the use of PTH analogues like teriparatide and abaloparatide?

    <p>They have been linked to an increased risk of osteosarcoma in laboratory animals.</p> Signup and view all the answers

    What is the maximum recommended duration of use for teriparatide (Forteo) or abaloparatide (Tymlos)?

    <p>The maximum recommended duration is 2 years.</p> Signup and view all the answers

    What is the effect of using bisphosphonates for more than 4 years?

    <p>Using bisphosphonates for more than 4 years is currently under review concerning efficacy or safety.</p> Signup and view all the answers

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