Comprehensive Final Test (Qns & Ans)
2025
Question 1 (Multiple Choice)
A 65‑year‑old postmenopausal woman with a history of long‑term
corticosteroid use presents with a compression fracture of the
vertebra following minimal trauma. Her DEXA scan shows a
T‑score of –2.8. Which of the following best explains the
pathophysiology of her condition?
A) Increased osteoblast activity
B) Excess PTH secretion
C) Enhanced osteoclast-mediated bone resorption secondary to
corticosteroid use
D) Genetic defect in collagen type I synthesis
Correct ANS:
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,C) Enhanced osteoclast-mediated bone resorption secondary to
corticosteroid use
Rationale:
Chronic corticosteroid exposure impairs osteoblast function and
promotes osteoclast-mediated bone resorption, leading to
decreased bone mineral density (osteoporosis) and an increased
risk of fragility fractures.
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Question 2 (Fill in the Blank)
The differentiation and activation of osteoclasts are primarily
stimulated by the binding of ______ to its receptor (RANK), a
process essential for bone resorption.
Correct ANS:
RANK ligand (RANKL)
Rationale:
RANKL is critical for osteoclast differentiation and activation. Its
interaction with the RANK receptor on osteoclast precursors
drives bone resorption, particularly in conditions such as
osteoporosis.
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Question 3 (True/False)
Pathologic fractures occurring with minimal trauma are a
hallmark feature of osteoporosis and result from reduced bone
mass and microarchitectural deterioration.
Correct ANS:
True
Rationale:
Osteoporosis causes significant decreases in bone mineral density
and deterioration in bone structure, making fractures likely even
with minor injury.
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Question 4 (Multiple Response)
Select all risk factors that predispose postmenopausal women to
osteoporosis:
A) Early onset of menopause
B) Sedentary lifestyle
C) Calcium and vitamin D deficiency
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, D) Smoking
E) High body mass index (BMI)
Correct ANS:
A, B, C, D
Rationale:
Early menopause, sedentary lifestyle, inadequate calcium/vitamin
D intake, and smoking are well-established risk factors for
osteoporosis, whereas a high BMI is generally protective.
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Question 5 (Multiple Choice)
A 45‑year‑old woman presents with symmetric joint pain,
prolonged morning stiffness, and positive rheumatoid factor.
Which cytokine is most responsible for mediating the joint
inflammation seen in rheumatoid arthritis?
A) Interleukin‑1 (IL‑1)
B) Interleukin‑6 (IL‑6)
C) Tumor necrosis factor‑alpha (TNF‑α)
D) Interleukin‑10 (IL‑10)
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