Peak bone mass in the adult skeleton is typically achieved by which age range?
Bone Physiology
Question · Easy
Which cell type is primarily responsible for bone resorption?
Chapter 1: Bone Biology, Microarchitecture & Remodeling
1.1 Bone Anatomy, Cellular Composition & Matrix
Study guide
Cortical bone comprises approximately what percentage of the adult skeleton?
Question · Medium
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RANKL produced by osteoblasts and stromal cells binds to RANK on osteoclast precursors. Which endogenous decoy receptor inhibits this interaction?
Question · Hard
Which Wnt pathway inhibitor secreted by osteocytes is the target of romosozumab?
Which two minerals are the primary constituents of hydroxyapatite, the inorganic phase of bone?
1.2 The Bone Remodeling Cycle & Molecular Regulation
Which is the most abundant non-collagenous protein in bone matrix and a marker of bone formation?
Which serum bone turnover marker is the preferred RESORPTION marker in clinical practice?
Calcitriol (1,25-dihydroxyvitamin D) is produced primarily by which enzyme and tissue?
Which laboratory test is the BEST single measure of vitamin D status?
1.3 Peak Bone Mass, Calcium Homeostasis & Skeletal Aging
Hyperparathyroidism causes preferential loss of which bone compartment?
Which condition causes the FASTEST rate of bone loss in the postmenopausal years?
Glucocorticoid-induced osteoporosis (GIO) causes most bone loss through which dominant mechanism?
Modeling differs from remodeling in that modeling:
Chapter 2: Bone Turnover Biomarkers & Fragility Pathophysiology
2.1 Biochemical Markers of Bone Turnover
Which fracture is considered an 'osteoporotic' or 'fragility' fracture per ISCD guidance?
Atypical femoral fractures (AFF) are most strongly associated with which medication class?
DXA quantifies bone mineral density by exploiting the differential attenuation of two:
Imaging Technologies
DXA reports bone mineral density in which units?
2.2 Pathophysiology of Bone Fragility & Fracture Healing
Quantitative computed tomography (QCT) of the spine differs from DXA in that QCT:
Which statement BEST describes the radiation exposure from a typical PA spine and hip DXA scan?
Per ISCD Official Positions, daily quality control on a DXA scanner should include:
After a scanner is repaired and a phantom shift is detected, what must occur before patient results can be compared to historical scans on that machine?
2.3 Epidemiology & Skeletal Morbidity of Fractures
Quantitative ultrasound (QUS) of the calcaneus differs from DXA in that QUS:
Trabecular Bone Score (TBS) is derived from which DXA acquisition?
Per ISCD Official Positions, TBS values are most likely to alter clinical management when:
Per ISCD 2023 positions, TBS should be calculated using which lumbar levels?
2.4 Economic Burden of Fractures
Vertebral Fracture Assessment (VFA) using DXA has which dose advantage compared with conventional lateral spine radiography?
On a DXA scanner using Hologic equipment, T-scores are derived from which manufacturer/reference database?
Which position is NOT a recommended ISCD acquisition technique for the PA lumbar spine?
When acquiring a hip DXA, the femoral shaft should be positioned how?
Chapter 3: DXA Physics, Instrumentation & Quality Control
3.1 Physical Principles of Dual-Energy X-Ray Absorptiometry
When forearm DXA is performed, ISCD specifies measurement at which region?
ALARA (radiation safety) principles in DXA imaging primarily mean:
Image artifacts that can falsely INCREASE PA spine BMD include which of the following?
On a DXA scanner serving a clinic with multiple technologists, an in vivo precision study is required:
3.2 Radiation Safety, Dosimetry & Regulatory Standards
Per the WHO operational definition (and endorsed by ISCD for postmenopausal women and men >=50 years), osteoporosis is diagnosed by DXA when the T-score is:
Interpretation
A T-score is calculated as the patient's BMD minus the YOUNG-ADULT mean BMD, divided by:
A Z-score of -2.0 or lower is described per ISCD as:
In a 35-year-old premenopausal woman undergoing DXA for chronic glucocorticoid therapy, which scoring system should be used for diagnosis?
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