PT 8390 Case Management II
Osteoporosis Quiz, not for a grade
28. T F
False
A person with osteoporosis and kyphosis cannot recover height that has been lost.
(Meeks) Clinical experience shows that up to one to two inches in height
can be gained or restored through a comprehensive regimen of diet, medicine and PT.
29. T F
A person can lose spinal height without exhibiting kyphotic posture.
True
Disc dehydration may be the cause of spinal height loss, unrelated to osteoporosis. Also,
bi-concave (codfish) [ younger person with osteomalacia: hydrated disc and soft bodies] and crush
vertebral fractures [MVA, SCI] will cause the loss of spinal height, but not the resulting kyphosis of the
more common wedge compression fractures
Height can also be lost due to: thinning of cartilage in weight bearing joints, and forefoot pronation..
30. T F
False
Cortical bone is not diminished from osteoporosis.
(Aisenberry) While cancellous bone is the most metabolically active and the first to
decrease, with advanced cases the cortical bone will also thin.
31. T F
True
BMD in elite swimmers does not differ from non-athletic controls.
(Nilsson) The strenous resistive exercise is insufficient to compensate
for the lack of weight bearing exercise.
32. T F
True
BMD in professional bicyclists is lower than non-athletic controls.
(Sabo) Tour de France bicyclists(n = 8) showed decreased bone mass of 10%
at the L spine and a decrease of 14% at the hip relative to age matched normals.
33.
In the mature adult 25% of the cancellous bone is renewed every year, but only 3% of the
cortical bone is renewed.
TF
True
34. T F
Low levels of Vitamin D impair the absorption of calcium from the gut. This results in less
calcium being resorbed from the bones.
False
When serum calcium levels fall (in this case due to poor absorption from the gut because of
inadequate Vitamin D), calcium is withdrawn from the “bone bank” to maintain homeostasis in the blood to
be made available for prioritized organ systems in the body such as heart, muscles, and nerves. The
parathyroid gland release PTH to accomplish this.
35. T F
True
When cortical bone is lost it results in increased endosteal diameter.
And when cancellous bone is lost, the trabeculae are thinned.
36. T F
Fracture risk increased two to three fold for every drop of 1 SD in bone mass at any give
site.
(Smith) This effect increases in magnitude with advancing age, and thus the cited ratio is
only an approximation. The calculation of fracture risk should include multiple factors.
True
37. T F
A “Dowager’s Hump” indicates thoracic compression fractures.
Usually, but not always. The “hump” can be a fibrous-fatty mass unrelated to kyphosis and osteoporosis.
38. T F
True.
Serum hypocalcemia will trigger the Parathyroid glands to release PTH which stimulates
osteoclast activity and bone resorption.
When the parathyroid glands perceive a hypocalcemic state, they mediate increased bone
resorption to restore calcium homeostasis in the blood stream … but bone homeostasis can
potentially suffer a net loss. The heart, skeletal muscles and nerves get their Ca supply first,
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sometimes at the expense of the “bone bank”. [Analogy to pregnancy and the fetus getting
nutritional priority – and the old saying “Have a baby, lose a tooth”]
Conversely, serum hypercalcemia will trigger the thyroid to release calcitonin to stimulate
osteoblast activity. In this case the bones have a chance to restore their loss and return to a more
balanced homeostasis.
39.
True
TF
The diaphyses of long bones largely consist of cortical or compact bone.
40. T F
False
You read the nutrition information on a 6 oz. carton of yogurt and it says: “20% of Daily
Value of Calcium”. This is equivalent to 100 mg of Calcium.
41. T F
False
DEXA T-scores norm the patient’s data to their current age group.
42.
The recommended amount of calcium for my age / life stage is ______. I regularly get that
amount from my diet and / or supplements.
TF
43. T F
True
At least 55% of people over the age of 50 have osteoporosis
– NOF -- *** Lead-in to Meek’s Algorithm ***
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