Download Bone Density Registry Review| 141 Questions all Answered correctly| Success Guaranteed| 20 and more Exams Nursing in PDF only on Docsity!
Bone Density Registry Review| 141 Questions
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According to the WHO criteria, for the diagnosis of osteoporosis, based on the measurement of bone density is 2.5 standard deviations or more below the young adult peak bone density Name the current gold standard technique for measuring bone density DXA Cancellous bone is also known as what? Trabecular bone What is the anatomical landmark of the proximal femur that indicates the best visual indication of the degree of rotation of the proximal femur? Lesser trochanter Which lumbar vertebra is described as having a characteristic shape of an X or H on a DXA PA spine scan? L Name all of the bisphosphonates for prevention and treatment of osteoporosis Alendronate, risedronate, ibandronate Name the bisphosphonate for treatment only of osteoporosis Zolendronic acid (Reclast)
What medication used to be classified as a SERM and is an estrogen agonist/antagonist and reduces breast cancer Ralaxofene (Evista) Is Forteo a bisphosphonate? No, it's an anabolic Quantitative computed tomography or QCT results are usually reported in Grams per cubic centimeter g/cm Quantitative computed tomography is Volumetric measurement of 100% trabecular bone at the spine Peripheral bone mineral density measurements are advocated for Screening What is the most important clinical consequence of osteoporosis? Fracture What is the name of the tool that integrates clinical information in a quantitative manner to predict a ten-year probability of major osteoporotic fracture for both men and women? FRAX Ability to measure true value and most important for DXA and assessment of fracture risk Accuracy
Generally after age 70 What technique used images of the hand and an aluminum wedge? Radiographic absorptiometry RA New bone is formed by the Osteoblasts Cancellous bone is also known as Trabecular bone How would you start labeling the vertebral bodies on a PA lumbar scan? Start at L4 and count up With changes in rotation of the femoral neck, what happens? Increases the BMD In the United States, if the daily QC fails, what should be your first step of action? Repeat the scan According to WHO, if a healthy female age 36 with no known medical condition present and all body parts working properly has a T score of - 1.6 SD, how would she be diagnosed? Normal, osteopenia, osteoporosis, none of the above None of the above, WHO criteria is only for postmenopausal women The primary mechanism of action of anti-resorptive therapies is the direct interaction with the Osteoclasts
Since fracture risk is best assessed in women over the age of 60, and because degenerative artifacts can interfere with spine BMD measurements in older women, which site is preferred for determination of fracture prediction? Proximal femur Phantoms that mimic the shape and size of a skeletal region are called Anthromomorphic phantoms How is bone mineral density calculated? BMC/Area How is bone mineral content calculated? BMD x Area Radiogrammetry is the measurement of bones using skeletal x-rays/radiographs. Which site was often used? Metacarpals With the voltage switching units, what type of calibration is used? Continuous internal calibration - wheel or drum For low energies, the most common process of absorption is the Photo electric affect What is the bone edge detection methodology? It tests the machines ability to distinguish bone from soft tissue What are the two most common methods for shifting the energies in DXA units?
What therapy mimics the effects of estrogen on bone and has anti-estrogenetic effects in other tissue? Ralaxofene (Evista) In both men and women, bone mass increases until approximately what age? 30 years If you get a new DXA unit, what must be performed in order to compare studies? Cross calibration - it compares the old machine to the new one Which acronym describes the least amount of BMD change that can be statistically significant? LSC - least significant change Two types of bone Cortical and trabecular When a patient comes back for a follow up study, regarding the rate of change, what parameters are being used to calculate the rate of change? BMD The shoulders of the patient should be squared with their Pelvis What are the preferred sites for the measurement of bone density in children? Spine and total body less head What percentage of the skeletal body mass is cortical bone?
On a DXA report, the bone mineral density is expressed as Grams per centimeter squared g/cm How many times should you scan a patient with in vevo precision study? 30 patients and scan them twice, 15 patients and scan them three times How many places to the right of the decimal point is used in reporting BMD? 3 The name of the forearm sites are based on what? The location of the site on the bone in relationship to the overall length of the ulna A post menopausal woman with a femoral neck T score of - 2.0 SD below a young adult is to be classified as Osteopenia What happens when there is an in balance or uncoupling of the remodeling cycle? Net loss in bone mass A technologist should perform a precision study in order to Calculate the LSC Regarding the Shewart Rules, the control limits are based on what percentage of the average values? 1.5% The sum of the data values divided by the number of values
What is the name of the isotope used in dual photon absorptiometry Gadolinium - 153 What bone parameter is measured in grams? BMC What does the wards area cover? The region of the proximal femur lying on the border of the femoral neck and the greater trochanter What has the highest percentage of cortical bone? 33% radius What is the age range used with FRAX? 40 to 90 years To determine the least significant change at 95% confidence level for baseline and one follow-up scan, what is the number which the precision air is multiplied to determine the least significant change?
What skeletal site may be preferred for assessing early menopause following an oophorectomy? Spine An increase in the overall bone mass of a patient is closely related to an accelerated rate of bone
Formation and a reduced amount of resorption QCT spine measures more of what type of bone? Trabecular What are the four classifications that apply to the heel? Appendicular, peripheral, predominately trabecular and weight-bearing Currently, the most accurate method to determine a patient's response to therapy for osteoporosis is Serial DXA measurements of the proximal femur and spine All follow up DXA scans should be compared to Baseline scan With long-term use of steroids, what type of bone would be affected and why? Trabecular because it has a higher metabolic rate so it's lost faster If a patient has a history of a laminectomy, how would that affect the results? Decrease BMD In the United States, approximately how many people are affected with low bone mass? 54 million True or false: Alendronate is the only anabolic agent approved for treatment of osteoporosis in the United States False - Forteo
Sievert refers to Effective dose True or false: the ultra distal part of the forearm is mostly cortical bone False True or false: a post menopausal woman with a T score of - 2.5 SD is considered to have osteopenia False True or false: accuracy is most important for diagnosis, less important for serial monitoring True True or false: standard scores indicate how many standard deviation's above or below the average value in question actually lies True True or false: precision is the ability to reproduce a measurement when performed under identical conditions True True or false: with QCT, the results are reported in grams per centimeter squared False True or false: the Tanner WhiteHouse method TW2 is often used to indicate bone age in children
True True or false: type to primary osteoporosis occurs as a side effect to certain medications False True or false: in early menopausal women, cortical bone is primarily affected False True or false: in regards to the international Society for clinical densitometry 2015 official positions, osteoporosis cannot be diagnosed in men under the age of 50 on the basis of BMD alone True True or false: the T score is the number of SD and individuals BMD is from the average BMD for sex matched young normal peak bone mass True True or false: quantitative ultrasound measures the broadband attenuation properties of bone True True or false: ralaxofene is a hormone False True or false: T scores are useful for the expression of relative risk True
For T-scores, the mean value is assigned a value of 50 For each standard deviation change, the T score will increase or decrease by a value of 10 The fan beam has what type of detector system question Solid-state/Multi element array The fan beam scan arm motion is Linear How close the measured values are to each other. Reflects the reproducibility of a measurement Precision How close a measured value is to the actual true value. Reflects the degree to which the measured results deviate from the values Accuracy Makes sure you are doing the right things the right way Quality assurance Make sure the results of what you've done or what you expected Quality control Verify the correct operation of the densitometer
QA tests Examine the functionality, as well as the accuracy and Precision of the densitometer QC tests Men account for approximately what percentage of all fractures? 20% How is pediatric osteoporosis defined? BMD below - 2 in combination with a fracture How is pediatric osteopenia define? Osteopenia is no longer used in pediatrics. It is now called low for age How far should the technologist be from the scanner? 3 feet What are considered central sites of the bone? Thoracic spine, lumbar spine, proximal femur Five factors that affect peak bone mass Genetic, endocrine, nutritional, lifestyle, medications Name 2 endocrine medical conditions that can affect peak bone mass Turners syndrome or hypoestrogenism, hyperparathyroidism
