,QUESTION: Which of the following does NOT result in falsely elevated bone mineral
density (BMD) of the spine during DXA?
A. Spinal cord compression
B. Compression fractures
C. Severe scoliosis
D. Osteophytosis
ANSWER: A. Spinal cord compression
Rationale:
Falsely elevated spinal BMD on DXA can occur due to structural changes such as compression
fractures, scoliosis, and osteophyte formation. Spinal cord compression itself does not alter bone
density measurements.
QUESTION: What is the correct sequence of the bone remodeling cycle?
A. Resorption → Formation → Activation → Reversal
B. Activation → Resorption → Reversal → Formation
C. Formation → Activation → Resorption → Reversal
D. Activation → Formation → Resorption → Reversal
ANSWER: B. Activation → Resorption → Reversal → Formation
Rationale:
Bone remodeling begins with activation of osteoclasts, followed by bone resorption, reversal,
and then new bone formation by osteoblasts.
QUESTION: Romosozumab-aqqp (Evenity) works primarily by which mechanism?
A. Inhibiting osteoclast activity
B. Stimulating osteoblastic bone formation
C. Blocking estrogen receptors
D. Reducing calcium absorption
ANSWER: B. Stimulating osteoblastic bone formation
Rationale:
Romosozumab is a sclerostin inhibitor that increases bone formation by stimulating osteoblast
activity.
QUESTION: Romosozumab-aqqp (Evenity) is administered as:
A. Daily oral therapy
B. Weekly oral therapy
C. Monthly injections for 12 months
D. Yearly IV infusion
ANSWER: C. Monthly injections for 12 months
,Rationale:
Evenity is given as two injections once monthly for a total treatment duration of 12 months.
QUESTION: Which of the following is classified as an anabolic agent for osteoporosis
treatment?
A. Denosumab
B. Risedronate
C. Romosozumab
D. Zoledronic acid
ANSWER: C. Romosozumab
Rationale:
Anabolic agents stimulate bone formation. Romosozumab is a sclerostin inhibitor with anabolic
effects.
QUESTION: Which medication acts as an estrogen agonist on bone but an antagonist on
breast and uterine tissue?
A. Estrogen
B. Denosumab
C. Raloxifene
D. Alendronate
ANSWER: C. Raloxifene
Rationale:
Raloxifene is a selective estrogen receptor modulator (SERM) that protects bone while reducing
breast and uterine stimulation.
QUESTION: Which of the following is a known side effect of raloxifene (Evista)?
A. Hypocalcemia
B. Osteonecrosis of the jaw
C. Deep vein thrombosis (DVT)
D. Renal failure
ANSWER: C. Deep vein thrombosis (DVT)
Rationale:
Raloxifene increases the risk of venous thromboembolism, including DVT, and may also cause
hot flashes and leg cramps.
QUESTION: Which adverse effect is associated with estrogen hormone therapy?
A. Reduced risk of stroke
B. Decreased breast cancer risk
C. Increased risk of DVT
D. Reduced cardiovascular risk
ANSWER: C. Increased risk of DVT
, Rationale:
Estrogen therapy increases the risk of thromboembolic events, stroke, myocardial infarction, and
breast cancer.
QUESTION: Denosumab (Prolia) prevents bone loss by:
A. Stimulating osteoblasts
B. Increasing calcium absorption
C. Preventing osteoclast development
D. Acting as a bisphosphonate
ANSWER: C. Preventing osteoclast development
Rationale:
Denosumab is a RANK ligand inhibitor that blocks osteoclast formation, reducing bone
resorption.
QUESTION: How often is denosumab (Prolia) administered?
A. Weekly
B. Monthly
C. Every 6 months
D. Annually
ANSWER: C. Every 6 months
Rationale:
Denosumab is given as a subcutaneous injection every six months.
QUESTION: Which of the following is a known adverse effect of denosumab?
A. Hot flashes
B. Hypocalcemia
C. Hypertension
D. Hypercalcemia
ANSWER: B. Hypocalcemia
Rationale:
Denosumab can lower calcium levels and is also associated with skin infections and
osteonecrosis of the jaw.
QUESTION: Zoledronic acid (Reclast) is best described as:
A. An oral anabolic agent
B. A RANK ligand inhibitor
C. An IV bisphosphonate that inhibits osteoclasts
D. A daily estrogen therapy
ANSWER: C. An IV bisphosphonate that inhibits osteoclasts
Rationale:
Zoledronic acid is an intravenous bisphosphonate that reduces bone resorption by inhibiting
osteoclast activity.
density (BMD) of the spine during DXA?
A. Spinal cord compression
B. Compression fractures
C. Severe scoliosis
D. Osteophytosis
ANSWER: A. Spinal cord compression
Rationale:
Falsely elevated spinal BMD on DXA can occur due to structural changes such as compression
fractures, scoliosis, and osteophyte formation. Spinal cord compression itself does not alter bone
density measurements.
QUESTION: What is the correct sequence of the bone remodeling cycle?
A. Resorption → Formation → Activation → Reversal
B. Activation → Resorption → Reversal → Formation
C. Formation → Activation → Resorption → Reversal
D. Activation → Formation → Resorption → Reversal
ANSWER: B. Activation → Resorption → Reversal → Formation
Rationale:
Bone remodeling begins with activation of osteoclasts, followed by bone resorption, reversal,
and then new bone formation by osteoblasts.
QUESTION: Romosozumab-aqqp (Evenity) works primarily by which mechanism?
A. Inhibiting osteoclast activity
B. Stimulating osteoblastic bone formation
C. Blocking estrogen receptors
D. Reducing calcium absorption
ANSWER: B. Stimulating osteoblastic bone formation
Rationale:
Romosozumab is a sclerostin inhibitor that increases bone formation by stimulating osteoblast
activity.
QUESTION: Romosozumab-aqqp (Evenity) is administered as:
A. Daily oral therapy
B. Weekly oral therapy
C. Monthly injections for 12 months
D. Yearly IV infusion
ANSWER: C. Monthly injections for 12 months
,Rationale:
Evenity is given as two injections once monthly for a total treatment duration of 12 months.
QUESTION: Which of the following is classified as an anabolic agent for osteoporosis
treatment?
A. Denosumab
B. Risedronate
C. Romosozumab
D. Zoledronic acid
ANSWER: C. Romosozumab
Rationale:
Anabolic agents stimulate bone formation. Romosozumab is a sclerostin inhibitor with anabolic
effects.
QUESTION: Which medication acts as an estrogen agonist on bone but an antagonist on
breast and uterine tissue?
A. Estrogen
B. Denosumab
C. Raloxifene
D. Alendronate
ANSWER: C. Raloxifene
Rationale:
Raloxifene is a selective estrogen receptor modulator (SERM) that protects bone while reducing
breast and uterine stimulation.
QUESTION: Which of the following is a known side effect of raloxifene (Evista)?
A. Hypocalcemia
B. Osteonecrosis of the jaw
C. Deep vein thrombosis (DVT)
D. Renal failure
ANSWER: C. Deep vein thrombosis (DVT)
Rationale:
Raloxifene increases the risk of venous thromboembolism, including DVT, and may also cause
hot flashes and leg cramps.
QUESTION: Which adverse effect is associated with estrogen hormone therapy?
A. Reduced risk of stroke
B. Decreased breast cancer risk
C. Increased risk of DVT
D. Reduced cardiovascular risk
ANSWER: C. Increased risk of DVT
, Rationale:
Estrogen therapy increases the risk of thromboembolic events, stroke, myocardial infarction, and
breast cancer.
QUESTION: Denosumab (Prolia) prevents bone loss by:
A. Stimulating osteoblasts
B. Increasing calcium absorption
C. Preventing osteoclast development
D. Acting as a bisphosphonate
ANSWER: C. Preventing osteoclast development
Rationale:
Denosumab is a RANK ligand inhibitor that blocks osteoclast formation, reducing bone
resorption.
QUESTION: How often is denosumab (Prolia) administered?
A. Weekly
B. Monthly
C. Every 6 months
D. Annually
ANSWER: C. Every 6 months
Rationale:
Denosumab is given as a subcutaneous injection every six months.
QUESTION: Which of the following is a known adverse effect of denosumab?
A. Hot flashes
B. Hypocalcemia
C. Hypertension
D. Hypercalcemia
ANSWER: B. Hypocalcemia
Rationale:
Denosumab can lower calcium levels and is also associated with skin infections and
osteonecrosis of the jaw.
QUESTION: Zoledronic acid (Reclast) is best described as:
A. An oral anabolic agent
B. A RANK ligand inhibitor
C. An IV bisphosphonate that inhibits osteoclasts
D. A daily estrogen therapy
ANSWER: C. An IV bisphosphonate that inhibits osteoclasts
Rationale:
Zoledronic acid is an intravenous bisphosphonate that reduces bone resorption by inhibiting
osteoclast activity.
