Osteoporosis Question Bank

Question 1
Which of the following bisphosphonates has the lowest antiresorptive activity?

A) Alendronate
B) Zoledronic Acid
C) Etidronate
D) Risedronate
E) Pamidronate

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Question 2
Which of the following is a serious side effect associated with long-term bisphosphonate therapy?

A) Hypertension
B) Osteonecrosis of the jaw (ONJ)
C) Hypercalcemia
D) Seizures
E) Hair loss

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Question 3
Which of the following bisphosphonates is administered intravenously once yearly for the treatment of osteoporosis?

A) Alendronate
B) Pamidronate
C) Etidronate
D) Zoledronic Acid
E) Risedronate

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Question 4
Which of the following is a contraindication to bisphosphonate therapy?

A) Hypertension
B) Hypocalcemia
C) Anemia
D) Hyperthyroidism
E) Liver disease

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Question 5
Which of the following is an important counseling point for patients taking oral bisphosphonates?

A) Take the medication with a meal to enhance absorption
B) Avoid lying down for at least 30 minutes after taking the medication
C) Take the medication at bedtime
D) Take the medication with milk to reduce gastrointestinal side effects
E) No dietary restrictions are necessary

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Question 6
A 72-year-old woman with osteoporosis is prescribed etidronate for bone density improvement. She is also taking calcium supplements. What advice should be provided regarding the administration of her calcium supplements during the etidronate therapy?

A) Take calcium supplements with etidronate to maximize bone density improvement
B) Avoid calcium supplements during the 2-week etidronate cycle and resume supplementation afterward
C) Take calcium supplements 1 hour before etidronate for better absorption
D) Calcium supplements are unnecessary when taking bisphosphonates
E) Take calcium supplements immediately after taking etidronate to reduce GI irritation

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Question 7
A 65-year-old man is diagnosed with hypercalcemia. What hormone is most likely to be released in response to elevated calcium levels, and what is its primary effect?

A) Parathyroid hormone; increases bone resorption
B) Calcitonin; decreases bone resorption
C) Vitamin D; increases calcium absorption
D) Estrogen; increases calcium retention
E) Aldosterone; increases renal excretion of calcium

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Question 8
A 55-year-old woman takes levothyroxine for hypothyroidism and calcium supplements for bone health. What advice should the pharmacist provide regarding the timing of her medications?

A) Take levothyroxine and calcium supplements together for better absorption
B) Take calcium supplements in the morning and levothyroxine at night
C) Separate the administration of levothyroxine and calcium supplements by at least two hours
D) Take both medications with food to avoid gastrointestinal side effects
E) There are no significant interactions between calcium supplements and levothyroxine

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Question 9
A 70-year-old woman takes calcium supplements and alendronate for osteoporosis. She asks her pharmacist if she should take vitamin D along with her calcium. What is the correct advice?

A) Vitamin D should not be taken with calcium, as it interferes with absorption
B) Vitamin D should be taken at least 2 hours after calcium
C) Vitamin D should be taken along with calcium to enhance absorption
D) Vitamin D should be avoided when taking alendronate
E) Vitamin D has no effect on calcium absorption

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Question 10
A 65-year-old woman with osteoporosis is taking calcium supplements daily. She is also prescribed alendronate for her bone health. How should she schedule her medications for optimal absorption?

A) Take alendronate with calcium supplements first thing in the morning
B) Take alendronate first thing in the morning and calcium supplements with breakfast
C) Take calcium supplements and alendronate together with food
D) Take calcium supplements first thing in the morning and alendronate at night
E) Take alendronate and calcium supplements at the same time on an empty stomach

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Question 11
A 60-year-old woman is concerned about her risk of osteoporosis after menopause. She is interested in starting estrogen therapy. How does estrogen help in the management of osteoporosis?

A) Estrogen enhances calcium excretion to reduce calcium buildup in bones
B) Estrogen decreases bone density but prevents fractures
C) Estrogen enhances calcium retention, slows bone loss, and helps treat osteoporosis
D) Estrogen decreases calcium absorption in the intestines, reducing fracture risk
E) Estrogen has no effect on bone health

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Question 12
A 70-year-old man is diagnosed with osteoporosis and is advised to take calcium and vitamin D supplements. Why is it important for him to take both together?

A) Vitamin D prevents calcium-induced hypercalcemia
B) Vitamin D helps increase the absorption of calcium from the intestines
C) Vitamin D neutralizes the side effects of calcium supplements
D) Vitamin D helps reduce bone pain associated with calcium supplementation
E) Vitamin D prevents constipation caused by calcium supplements

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Question 13
A 68-year-old postmenopausal woman is concerned about her risk for osteoporosis. She asks her doctor about factors that could contribute to her condition. Which of the following is not a known risk factor for osteoporosis?

A) Chronic corticosteroid therapy
B) Early menopause
C) Obesity
D) Inadequate calcium and vitamin D intake
E) Age

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Question 14
A 60-year-old woman asks her doctor if drinking alcohol in moderation will increase her risk of osteoporosis. What is the most appropriate response?

A) Alcohol intake in moderation is a significant risk factor for osteoporosis
B) Alcohol intake is more likely to cause osteoporosis than coffee consumption
C) Moderate alcohol intake is less likely to be a risk factor compared to smoking and corticosteroid therapy
D) Alcohol intake should be eliminated completely to prevent osteoporosis
E) Alcohol intake and coffee consumption carry equal risks for osteoporosis

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Question 15
A 55-year-old man is diagnosed with osteoporosis and is interested in exercises to improve his bone strength. Which of the following is least likely to help strengthen his bones?

A) Weightlifting
B) Running
C) Walking
D) Swimming
E) Jumping

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Question 16
A 62-year-old man with osteoporosis is concerned about his risk factors. Which of the following is not considered a risk factor for osteoporosis?

A) Age
B) Malabsorption
C) Hypergonadism
D) High alcohol intake
E) Early menopause

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Question 17
A 70-year-old woman with osteoporosis is advised to start calcium supplements. She is also taking omeprazole for GERD. Which calcium supplement is the best option for her?

A) Calcium carbonate
B) Calcium citrate
C) Calcium gluconate
D) Calcium lactate
E) Calcium phosphate

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Question 18
A 65-year-old woman with a history of Crohn’s disease and an eating disorder is concerned about her bone health. Which of the following is not a risk factor for osteoporosis?

A) Crohn’s disease
B) Eating disorders
C) Gender (female)
D) Osteoarthritis
E) Rheumatoid arthritis

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Question 19
A 58-year-old man with osteoporosis asks about medications to prevent further bone loss. He has heard about raloxifene but is unsure if it is appropriate for him. Which of the following is the best response?

A) Raloxifene is used for osteoporosis prevention in both men and women
B) Raloxifene is only used for women, while bisphosphonates are more appropriate for men
C) Raloxifene is the first-line therapy for osteoporosis in men
D) Raloxifene is used in men to prevent both osteoporosis and cardiovascular disease
E) Raloxifene can be used in men with adequate calcium intake

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Question 20
A 65-year-old postmenopausal woman is prescribed cholecalciferol as part of her osteoporosis treatment. What is the best description of cholecalciferol?

A) Vitamin A
B) Vitamin D3
C) Vitamin K
D) Vitamin B12
E) Vitamin D2

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Question 21
A 65-year-old postmenopausal woman is prescribed alendronate 70 mg once weekly for osteoporosis treatment. Which of the following is the most appropriate instruction for her regarding administration?

A) Take alendronate with food to reduce GI upset
B) Take alendronate with a full glass of water at least 30 minutes before any food or beverages
C) Take alendronate right before bed to improve absorption
D) Take alendronate with calcium supplements to enhance efficacy
E) Take alendronate with a glass of milk to protect the stomach lining

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Question 22
A 70-year-old patient with severe osteoporosis is prescribed zoledronic acid 5 mg IV once yearly. Which of the following is the most important monitoring parameter during her treatment?

A) Blood pressure
B) Liver function tests
C) Serum calcium levels and renal function
D) Complete blood count
E) Weight monitoring

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Question 23
A 68-year-old man on bisphosphonate therapy for osteoporosis reports persistent thigh pain. X-rays reveal a transverse femoral fracture. What is the most likely cause of his symptoms?

A) Osteonecrosis of the jaw
B) Atypical femoral fracture due to long-term bisphosphonate use
C) Renal insufficiency
D) Gastrointestinal irritation from oral bisphosphonates
E) Esophageal ulceration

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Question 24
A 60-year-old woman with osteoporosis is scheduled for invasive dental work. She is currently on alendronate therapy. Which of the following is a significant risk she should be counseled on regarding her upcoming procedure?

A) Increased risk of atrial fibrillation
B) Risk of osteonecrosis of the jaw (ONJ)
C) Increased risk of gastrointestinal bleeding
D) Risk of atypical femoral fractures
E) Risk of renal failure

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Question 25
A 65-year-old woman with osteoporosis has been on risedronate therapy for 7 years. Her doctor is considering a drug holiday due to her moderate fracture risk. What is the most appropriate recommendation regarding the duration of a drug holiday for this patient?

A) Continue risedronate without a break
B) A drug holiday of 1-3 years is recommended
C) Discontinue risedronate permanently
D) Switch to another bisphosphonate during the drug holiday
E) Reduce the dose of risedronate during the holiday

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Question 26
A 58-year-old man is prescribed prednisone for an autoimmune condition. His doctor explains that long-term use of prednisone can lead to specific side effects. Which of the following is most likely to result from prolonged, high-dose prednisone use?

A) Increased muscle mass
B) Weight loss
C) Osteoporosis
D) Improved bone strength
E) Reduced risk of fractures

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Question 27
A 68-year-old woman with a history of corticosteroid use is concerned about her risk of osteoporosis. Which of the following factors is not a known risk factor for osteoporosis?

A) Prolonged corticosteroid use
B) Menopause
C) Being overweight
D) Smoking
E) Excessive alcohol intake

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Question 28
A 67-year-old woman asks her pharmacist about the recommended daily dose of calcium supplements for individuals over the age of 50. What is the most appropriate advice regarding calcium intake?

A) 500 mg daily
B) 800 mg daily
C) 1,000 mg daily
D) 1,200 mg daily
E) 1,500 mg daily

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Question 29
A 55-year-old woman with osteoporosis is prescribed bisphosphonates for her condition. She asks about the dosing options available for her medication. Which of the following is not a common dosing frequency for bisphosphonates?

A) Weekly
B) Monthly
C) Annually
D) Biweekly
E) Once daily

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Question 30
A 70-year-old woman is advised to take calcium supplements to prevent further bone loss due to osteoporosis. She is deciding between calcium carbonate and other forms of calcium supplements. Which option provides the most elemental calcium per dose?

A) Calcium citrate
B) Calcium gluconate
C) Calcium lactate
D) Calcium carbonate
E) Calcium phosphate

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Question 31
A 62-year-old postmenopausal woman is considering raloxifene for osteoporosis prevention. She has a history of hot flushes and hypertension but no history of thromboembolic events. What is the primary benefit of raloxifene for this patient?

A) Prevention of vertebral and non-vertebral fractures
B) Neuroprotection against degenerative diseases
C) Reduction in the risk of estrogen receptor-positive breast cancer
D) Reduction of hot flushes
E) Significant improvement in HDL and triglycerides

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Question 32
A 65-year-old postmenopausal woman with a high risk of vertebral fractures is prescribed bezedoxifene for osteoporosis prevention. She also takes conjugated estrogen for menopausal symptoms. What is the primary advantage of this combination therapy?

A) It provides neuroprotection and reduces the risk of stroke
B) It prevents endometrial hyperplasia without the need for additional progestin
C) It significantly reduces the risk of thromboembolic events
D) It enhances HDL levels and reduces triglycerides
E) It eliminates the need for any other osteoporosis treatment

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Question 33
A 58-year-old woman with a history of thromboembolic events is considering starting raloxifene for osteoporosis prevention. Which of the following factors makes raloxifene an inappropriate choice for her?

A) Increased risk of hot flushes
B) Inability to reduce non-vertebral fractures
C) Risk of worsening lipid profiles
D) Increased risk of deep vein thrombosis and pulmonary embolism
E) Lack of breast cancer protection

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Question 34
A 60-year-old postmenopausal woman is taking raloxifene for osteoporosis prevention. She is also prescribed cholestyramine for cholesterol management. What is the most important counseling point for this patient?

A) Cholestyramine will enhance the effects of raloxifene on bone density
B) Cholestyramine will reduce the absorption of raloxifene by up to 60%
C) Raloxifene will reduce the effectiveness of cholestyramine
D) Cholestyramine increases the risk of thromboembolic events with raloxifene
E) Both drugs should be taken together to maximize their benefits

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Question 35
A 64-year-old postmenopausal woman is interested in raloxifene to reduce her risk of vertebral fractures. She asks about the potential side effects. What is the most significant risk associated with raloxifene therapy in this patient?

A) Osteonecrosis of the jaw
B) Severe hot flushes
C) Atypical femoral fractures
D) Stroke, especially in women with predisposing cardiovascular risk factors
E) Gastrointestinal bleeding

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Question 36
A 70-year-old woman with osteoporosis is prescribed denosumab, a RANK ligand inhibitor, after failing bisphosphonate therapy. What is the mechanism of action of denosumab in the treatment of osteoporosis?

A) Inhibits osteoclast activity by binding to hydroxyapatite in bone
B) Increases osteoblast activity to enhance bone formation
C) Binds to RANK ligand, preventing its interaction with RANK on osteoclasts, thereby reducing bone resorption
D) Blocks estrogen receptors in bone, reducing osteoclast activity
E) Stimulates parathyroid hormone secretion to enhance calcium absorption

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Question 37
A 65-year-old woman with severe osteoporosis has been treated with denosumab for the past two years. She is concerned about long-term risks. What is a serious side effect associated with prolonged denosumab therapy?

A) Osteonecrosis of the jaw (ONJ)
B) Severe gastrointestinal irritation
C) Atypical femoral fractures
D) Stroke
E) Renal failure

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Question 38
A 58-year-old postmenopausal woman is about to start denosumab therapy for osteoporosis. What is the recommended dosing schedule for denosumab in the treatment of osteoporosis?

A) Once daily
B) Once weekly
C) Once monthly
D) Once every 3 months
E) Once every 6 months

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Question 39
A 62-year-old woman with osteoporosis is being treated with denosumab. She reports a recent dental extraction and is now experiencing jaw pain and swelling. What is the most likely diagnosis?

A) Osteonecrosis of the jaw (ONJ)
B) Acute osteomyelitis
C) Temporomandibular joint disorder
D) Gingivitis
E) Mandibular fracture

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Question 40
A 70-year-old patient with osteoporosis has been receiving denosumab injections for 3 years. She asks about potential complications of discontinuing the drug. What is the primary risk after stopping denosumab therapy?

A) Decreased calcium absorption
B) Increased risk of gastrointestinal bleeding
C) Rapid bone loss and increased fracture risk
D) Hypocalcemia
E) Hypertension

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Question 41
Which of the following best describes the primary action of teriparatide in the treatment of osteoporosis?

A) Inhibition of osteoclast activity
B) Stimulation of osteoblast activity
C) Inhibition of bone resorption
D) Promotion of calcium absorption in the kidneys
E) Increase in vitamin D synthesis

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Question 42
Which of the following is a common side effect of teriparatide therapy?

A) Hypertension
B) Leg cramps
C) Visual disturbances
D) Alopecia
E) Weight gain

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Question 43
For which of the following conditions is teriparatide therapy contraindicated?

A) Primary osteoporosis
B) Paget’s disease of bone
C) Glucocorticoid-induced osteoporosis
D) Osteopenia
E) Vitamin D deficiency

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Question 44
A 65-year-old woman is diagnosed with osteoporosis. She asks her doctor if her condition is caused by softening of her bones due to a lack of calcium. What is the best response?

A) Osteoporosis is primarily due to bone softening caused by calcium deficiency
B) Osteoporosis is not defined by bone softening; it involves decreased bone mass and strength
C) Osteoporosis results from a lack of calcium, leading to osteomalacia
D) Osteoporosis and osteomalacia are the same conditions
E) Osteoporosis is defined by the thickening of bones

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Question 45
Which of the following statements regarding the duration of teriparatide therapy is correct?

A) Teriparatide therapy should be limited to 6 months
B) Teriparatide therapy should be continued indefinitely as long as it is effective
C) Teriparatide therapy should not exceed 24 months over a patient’s lifetime
D) Teriparatide therapy can be used for up to 5 years
E) Teriparatide therapy duration depends on bone mineral density levels

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Question 46
Which of the following monitoring parameters is most important for patients on teriparatide therapy?

A) Serum cholesterol levels
B) Serum calcium levels
C) Liver function tests
D) Thyroid function tests
E) Blood pressure

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Question 47
A 68-year-old woman with a history of chronic kidney disease is prescribed denosumab for osteoporosis. What is the primary benefit of denosumab in patients with renal impairment?

A) Denosumab is not renally cleared, so it is safe for use in patients with renal impairment
B) Denosumab enhances renal calcium reabsorption
C) Denosumab stimulates erythropoietin production
D) Denosumab reduces proteinuria in renal disease
E) Denosumab helps reverse renal bone disease

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Question 48
A 72-year-old woman with osteoporosis is scheduled to receive her first dose of denosumab. What laboratory value should be monitored prior to initiating denosumab therapy?

A) Serum creatinine
B) Serum calcium
C) Complete blood count
D) Alkaline phosphatase
E) Serum potassium

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Question 49
A 55-year-old postmenopausal woman is considering raloxifene for osteoporosis prevention but is concerned about its effects on her cholesterol. Which of the following statements is correct regarding raloxifene’s effects on lipid metabolism?

A) Raloxifene significantly increases HDL and lowers triglycerides
B) Raloxifene lowers cholesterol and LDL but has little effect on HDL or triglycerides
C) Raloxifene raises LDL and cholesterol levels
D) Raloxifene improves all aspects of lipid metabolism
E) Raloxifene decreases triglycerides but has no effect on LDL

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