Osteoporosis

Question 1

Calcitonin MOA
a. Inhibits hydroxyapatite crystal formation, aggregation, and dissolution
b. Raises intracellular cAMP in osteoclasts
c. Activates bone resorption
d. Inhibits macrophages

Answer 1

b. Raises intracellular cAMP in osteoclasts

Question 2

Osteoclast function

Answer 2

.Catabolic activity
.Resorption of bone

Question 3

Osteoblast function

Answer 3

.Anabolic function
.Building bones

Question 4

Inherited deficiency of what two things may cause a form of osteopetrosis, which is defective bone resorption and increased bone mass?

Answer 4

RANK or RANKL

Question 5

Inherited deficiency of what may cause a form of osteoporosis, which is increased bone resorption and loss of bone mass?

Answer 5

OPG

Question 6

Osteoporosis agents can be classified in what two main categories?

Answer 6

Antiresorptive agents and bone anabolic agents

Question 7

Bisphosphonate MOA

Answer 7

Limit bone turnover and allow osteoblasts to form bone without opposition

Question 8

True or false: BPs are analogs of pyrophosphates. Their readily hydrolysable P-O-P bond is replaced by a nonhydrolyzable P-C-P bond

Answer 8

True

Question 9

Teriparatide (Forteo) MOA and BBW

Answer 9

MOA: Agonist at the PTH type 1 receptor, leading to increased osteoblast activity
BBW: Increased baseline risk of osteosarcoma

Question 10

Denosumab MOA

Answer 10

Binds to RANKL and prevent it from binding to RANK, reducing osteoclast activity

Question 11

What was the first bone anabolic agent?

Answer 11

Fluoride

Question 12

Fluoride MOA

Answer 12

Leads to the conversion of hydroxyapatite to fluorapatite, which is denser and more brittle

Question 13

Osteoporosis counseling should cover

Answer 13

.Calcium and vitamin D intake
.Weight bearing exercise
.Fall prevention
.Medication adherence

Question 14

Which medications can lead to osteoporosis?

Answer 14

.Glucocortiocoids (long term)
.Topical steroids
PPIs
SSRIs
Thiazolidinediones
.Phenytoin
.Aromatase inhibitors
.Lithium
.Methotrexate
.GnRH antagonists

Question 15

Who should be screened for osteoporosis?

Answer 15

.All post menopausal women
.All men over 50
.Women with pre-mature menopause

Question 16

What is the FRAX calculator used for?

Answer 16

10 yr hip fracture risk or major osteoporotic fracture risk

Question 17

What is considered gold standard imaging when diagnosing osteoporosis?

Answer 17

DEXA scan

Question 18

T-score classifications

Answer 18

Normal: -1.0 and above
Low bone mass: -1.0 to -2.5
Osteoporosis: -2.5 or below
Severe osteoporosis: -2.5 or below with one or more fractures