PracticeVideosBlogFlashcards
All Practice Exams

Free Practice Questions for ISCD CCD

Exam-style questions and explanations by OpenExamPrep.

✓ No registration✓ No credit card
106+ Questions
100% Free

Loading practice questions...

Same family resources

Explore More ISCD Bone Densitometry Certifications

Continue into nearby exams from the same family. Each card keeps practice questions, study guides, flashcards, videos, and articles in one place.

ISCD Certified Bone Densitometry Technologist

Practice Questions100 questions
Exam Review

Key Facts: ISCD CCD Exam

100

Multiple-Choice Questions

ISCD CCD Handbook

75

Passing Score

ISCD

100 min

Test Duration

ISCD

$400

Full/Professional Member Initial Fee

ISCD

5 years

Certification Validity

ISCD

The CCD exam is delivered online through the ISCD Learning Center: 100 multiple-choice questions in 100 minutes, with a published passing score of 75. Initial fees are $400 for Full/Professional Members and $725 for Community/Non-Members. Approved candidates have a 90-day eligibility window; certification is valid for five years.

Sample ISCD CCD Practice Questions

Try these sample questions to review concepts for the ISCD CCD exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 106+ question experience with AI tutoring.

1Peak bone mass in the adult skeleton is typically achieved by which age range?
A.Late teens to mid-20s
B.Mid-30s
C.Age 40-45
D.Age 50 (women) and age 60 (men)
Explanation: Peak bone mass is typically reached by the late second to mid-third decade of life (roughly ages 18-25). Genetics determines 60-80% of peak bone mass; modifiable factors include nutrition, weight-bearing activity, and avoiding tobacco and excessive alcohol.
2Which cell type is primarily responsible for bone resorption?
A.Osteoblast
B.Osteocyte
C.Osteoclast
D.Chondrocyte
Explanation: Osteoclasts are large multinucleated cells of hematopoietic (monocyte-macrophage lineage) origin that resorb bone by acidifying the resorption pit and secreting cathepsin K and matrix metalloproteinases. RANKL signaling from osteoblasts drives osteoclast differentiation; denosumab is a monoclonal antibody to RANKL.
3Cortical bone comprises approximately what percentage of the adult skeleton?
A.20%
B.50%
C.80%
D.100%
Explanation: The adult skeleton is about 80% cortical (compact) bone and 20% trabecular (cancellous) bone. Cortical bone forms the outer shell of long bones; trabecular bone predominates in vertebral bodies, the ends of long bones, and the pelvis. Trabecular bone has higher metabolic turnover and responds first to bone-active therapies.
4RANKL produced by osteoblasts and stromal cells binds to RANK on osteoclast precursors. Which endogenous decoy receptor inhibits this interaction?
A.Osteoprotegerin (OPG)
B.Sclerostin
C.FGF23
D.Calcitonin
Explanation: Osteoprotegerin (OPG) is a decoy receptor secreted by osteoblasts that binds RANKL and prevents it from activating RANK on osteoclasts, suppressing osteoclastogenesis. The RANK/RANKL/OPG axis is central to bone remodeling; denosumab is a fully human monoclonal antibody that mimics OPG by binding RANKL.
5Which Wnt pathway inhibitor secreted by osteocytes is the target of romosozumab?
A.DKK-1
B.Sclerostin
C.Noggin
D.Periostin
Explanation: Sclerostin, encoded by SOST and produced predominantly by osteocytes, inhibits Wnt-beta-catenin signaling and suppresses bone formation. Romosozumab is a humanized monoclonal antibody to sclerostin that increases bone formation and decreases bone resorption, used for one year in postmenopausal women at high fracture risk.
6Which two minerals are the primary constituents of hydroxyapatite, the inorganic phase of bone?
A.Magnesium and potassium
B.Calcium and phosphate
C.Sodium and chloride
D.Zinc and copper
Explanation: Hydroxyapatite [Ca10(PO4)6(OH)2] is the dominant crystalline mineral in bone, providing compressive strength and serving as the body's reservoir of calcium and phosphate. Type I collagen forms the organic matrix that gives bone its tensile strength.
7Which is the most abundant non-collagenous protein in bone matrix and a marker of bone formation?
A.Osteocalcin
B.Albumin
C.Hemoglobin
D.Cytokeratin
Explanation: Osteocalcin (bone Gla protein) is produced by osteoblasts, is vitamin K dependent, and is the most abundant non-collagenous protein in bone. Serum osteocalcin and procollagen type 1 N-propeptide (P1NP) are formation markers; CTX and NTX are resorption markers.
8Which serum bone turnover marker is the preferred RESORPTION marker in clinical practice?
A.P1NP
B.Bone-specific alkaline phosphatase
C.Serum CTX (C-terminal telopeptide of type I collagen)
D.Osteocalcin
Explanation: Serum CTX is the preferred resorption marker; it should be drawn fasting in the morning to minimize variability. P1NP is the preferred formation marker. CTX falls quickly with potent antiresorptives (bisphosphonates, denosumab) and is sometimes used to confirm adherence.
9Calcitriol (1,25-dihydroxyvitamin D) is produced primarily by which enzyme and tissue?
A.25-hydroxylase in liver
B.1-alpha-hydroxylase in proximal renal tubule
C.24-hydroxylase in distal nephron
D.Aromatase in gonads
Explanation: 1-alpha-hydroxylase (CYP27B1) in the proximal renal tubule converts 25-hydroxyvitamin D to active calcitriol. PTH up-regulates this enzyme, while FGF23 and high phosphate suppress it. Renal failure and rare 1-alpha-hydroxylase mutations cause calcitriol deficiency despite normal 25-OH-D.
10Which laboratory test is the BEST single measure of vitamin D status?
A.Serum 1,25-dihydroxyvitamin D
B.Serum 25-hydroxyvitamin D
C.Urine vitamin D
D.Serum vitamin D-binding protein
Explanation: Serum 25-hydroxyvitamin D (25-OH-D) is the accepted measure of vitamin D body stores because of its long half-life (~3 weeks) and stable serum levels. The Endocrine Society defines deficiency as <20 ng/mL and insufficiency as 21-29 ng/mL; ISCD positions are aligned with maintaining adequate stores for bone health.

About the ISCD CCD Exam

Clinician credential for DXA interpretation, fracture risk assessment, and osteoporosis management. The CCD exam tests ISCD Official Positions, T-score and Z-score interpretation, FRAX, VFA, TBS, and treatment thresholds.

Exam sponsor: ISCD. The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Assessment

100 multiple-choice questions through the ISCD Learning Center, online only. Access lasts 90 days after approval; once begun the 100-minute session cannot be paused.

Time Limit

1 hour 40 minutes

Passing Score

75 (ISCD published passing score)

Exam / Certification Fees

$400 Full/Professional Member; $725 Community/Non-Member

Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Official sources

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

16%

Overview of Bone Physiology

Bone development, structure, peak bone mass, remodeling, and bone biomarkers

20%

Imaging Technologies

DXA principles, QCT, pQCT, QUS, radiation safety, and quality control

33%

Interpretation

T-scores, Z-scores, BMD, LSC, ROI selection, VFA, TBS, reporting per ISCD Official Positions

16%

Risk Assessment

Epidemiology, risk factors, FRAX, secondary causes of bone loss, clinical evaluation

15%

Management

Lifestyle, calcium and vitamin D, bisphosphonates, denosumab, romosozumab, anabolics, and monitoring

Preparing for the ISCD CCD Exam

What You Need to Know

  • Passing score: 75 (ISCD published passing score)
  • Assessment: 100 multiple-choice questions through the ISCD Learning Center, online only. Access lasts 90 days after approval; once begun the 100-minute session cannot be paused.
  • Time limit: 1 hour 40 minutes
  • Exam / certification fees: $400 Full/Professional Member; $725 Community/Non-Member Official sources

Using Our Practice Resources

  • Work through all 106 available questions
  • Review every answer and explanation
  • Track weak areas and revisit them
  • Use our AI tutor for tough concepts

ISCD CCD: Suggested Study Strategy

1Memorize ISCD interpretation rules — when to exclude vertebrae, total hip vs femoral neck choice, and forearm 33% radius use
2Master FRAX treatment thresholds: NOF/Bone Health & Osteoporosis Foundation US thresholds are >=3% 10-year hip and >=20% major osteoporotic fracture risk
3Know VFA indications: T-score <-1.0 plus age, height loss, undocumented fracture, or chronic glucocorticoid use
4Learn the 2023 TBS positions: appropriate for adults >=40 years, use L1-L4 without exclusions, do not report with severe artifact
5Practice LSC math — change in BMD must exceed 2.77 x precision error to be significant

Frequently Asked Questions

What is the ISCD CCD exam?

CCD is the ISCD clinician credential for interpreting bone densitometry. Its examination covers five domains: bone physiology, imaging technologies, interpretation, risk assessment and management. It is offered online only through the ISCD Learning Center.

How many questions are on the CCD exam and how long is it?

100 multiple-choice questions through the ISCD Learning Center, online only. Access lasts 90 days after approval; once begun the 100-minute session cannot be paused.

What is the passing score for the CCD exam?

ISCD publishes a passing score of 75. Candidates receive their score report upon completing the examination. Certification is valid for five years.

How much does the CCD exam cost?

Current initial examination fees are $400 Full/Professional Member; $725 Community/Non-Member. Re-test fees are $225 and $300 for those same tiers. Optional membership and printed certificates are separate costs.

Who is eligible to take the CCD exam?

Clinicians interpreting bone densitometry: physicians, certified NPs/PAs, fellows, residents, and PhDs researching bone densitometry. Clinicians must be in good standing; fellows and residents need Program Director acknowledgement.

What ISCD Official Positions are tested on the CCD exam?

The exam tests the most current ISCD Official Positions. Key 2023 updates include the use of L1-L4 for Trabecular Bone Score (TBS) without exclusions, follow-up BMD testing intervals tied to predefined objectives, and revised DXA reporting requirements. The 2019 Adult, Pediatric, and FRAX Positions remain in scope along with the 2023 revisions.

How should I study for the CCD exam?

Use the current five-domain content outline and relevant ISCD Official Positions. The QBD course is optional; ISCD does not require or officially recommend a particular course or study material, and taking QBD does not guarantee a pass. Any study-hour estimate here is independent preparation advice.