NBME CBSE ACTUAL TEST QUESTIONS AND ANSWERS
(Testbank with complete solutions) (USMLE step 1) Medical
examination 2000+ Questions and answers
1.
A 68-year-old postmenopausal woman is started on alendronate. Which is the primary mechanism of action?
A. Stimulates osteoblasts
B. Inhibits osteoclast-mediated bone resorption
C. Increases intestinal calcium absorption
D. Increases parathyroid hormone secretion
Answer: B
2.
A patient on long-term glucocorticoids is at risk for osteoporosis primarily due to:
A. Increased osteoblast activity
B. Decreased osteoclast activity
C. Decreased bone formation
D. Increased calcitonin release
Answer: C
,3.
Which drug directly stimulates bone formation?
A. Alendronate
B. Denosumab
C. Teriparatide
D. Calcitonin
Answer: C
4.
A patient on bisphosphonates reports jaw pain and dental issues. This complication is most consistent with:
A. Osteomyelitis
B. Osteonecrosis of the jaw
C. Rheumatoid arthritis
D. Dental caries
Answer: B
5.
Which finding is most consistent with osteoporosis?
A. Increased bone density on X-ray
B. Normal calcium levels with low bone mass
C. High serum phosphate
D. Elevated PTH with hypercalcemia
Answer: B
6.
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,A postmenopausal woman develops osteoporosis due to decreased:
A. Testosterone
B. Estrogen
C. Progesterone
D. Cortisol
Answer: B
7.
Which medication is a monoclonal antibody that inhibits RANKL?
A. Alendronate
B. Calcitonin
C. Denosumab
D. Raloxifene
Answer: C
8.
Denosumab works by:
A. Stimulating osteoclasts
B. Blocking osteoclast activation
C. Increasing calcium excretion
D. Increasing vitamin D metabolism
Answer: B
9.
A patient has osteoporosis. Which lab finding is most likely normal?
A. Serum calcium
B. PTH elevated
C. Phosphate elevated
D. ALP markedly elevated
Answer: A
10.
Which is the most appropriate first-line therapy for postmenopausal osteoporosis?
, A. Teriparatide
B. Bisphosphonates
C. Calcitonin
D. Estrogen in all patients
Answer: B
11.
A patient taking bisphosphonates should be instructed to:
A. Lie down immediately after taking it
B. Take with milk
C. Remain upright for 30–60 minutes
D. Take at bedtime with food
Answer: C
12.
Why must bisphosphonates be taken on an empty stomach?
A. To prevent hypoglycemia
B. To increase absorption
C. To prevent renal toxicity
D. To avoid liver metabolism
Answer: B
13.
Long-term estrogen deficiency leads to osteoporosis due to:
A. Increased osteoblast apoptosis
B. Increased osteoclast activity
C. Increased calcium absorption
D. Decreased vitamin D
Answer: B
14.
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(Testbank with complete solutions) (USMLE step 1) Medical
examination 2000+ Questions and answers
1.
A 68-year-old postmenopausal woman is started on alendronate. Which is the primary mechanism of action?
A. Stimulates osteoblasts
B. Inhibits osteoclast-mediated bone resorption
C. Increases intestinal calcium absorption
D. Increases parathyroid hormone secretion
Answer: B
2.
A patient on long-term glucocorticoids is at risk for osteoporosis primarily due to:
A. Increased osteoblast activity
B. Decreased osteoclast activity
C. Decreased bone formation
D. Increased calcitonin release
Answer: C
,3.
Which drug directly stimulates bone formation?
A. Alendronate
B. Denosumab
C. Teriparatide
D. Calcitonin
Answer: C
4.
A patient on bisphosphonates reports jaw pain and dental issues. This complication is most consistent with:
A. Osteomyelitis
B. Osteonecrosis of the jaw
C. Rheumatoid arthritis
D. Dental caries
Answer: B
5.
Which finding is most consistent with osteoporosis?
A. Increased bone density on X-ray
B. Normal calcium levels with low bone mass
C. High serum phosphate
D. Elevated PTH with hypercalcemia
Answer: B
6.
2 of 40
,A postmenopausal woman develops osteoporosis due to decreased:
A. Testosterone
B. Estrogen
C. Progesterone
D. Cortisol
Answer: B
7.
Which medication is a monoclonal antibody that inhibits RANKL?
A. Alendronate
B. Calcitonin
C. Denosumab
D. Raloxifene
Answer: C
8.
Denosumab works by:
A. Stimulating osteoclasts
B. Blocking osteoclast activation
C. Increasing calcium excretion
D. Increasing vitamin D metabolism
Answer: B
9.
A patient has osteoporosis. Which lab finding is most likely normal?
A. Serum calcium
B. PTH elevated
C. Phosphate elevated
D. ALP markedly elevated
Answer: A
10.
Which is the most appropriate first-line therapy for postmenopausal osteoporosis?
, A. Teriparatide
B. Bisphosphonates
C. Calcitonin
D. Estrogen in all patients
Answer: B
11.
A patient taking bisphosphonates should be instructed to:
A. Lie down immediately after taking it
B. Take with milk
C. Remain upright for 30–60 minutes
D. Take at bedtime with food
Answer: C
12.
Why must bisphosphonates be taken on an empty stomach?
A. To prevent hypoglycemia
B. To increase absorption
C. To prevent renal toxicity
D. To avoid liver metabolism
Answer: B
13.
Long-term estrogen deficiency leads to osteoporosis due to:
A. Increased osteoblast apoptosis
B. Increased osteoclast activity
C. Increased calcium absorption
D. Decreased vitamin D
Answer: B
14.
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