Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

FNH 351 > Bone Mineral Multiple Choice Questions > Flashcards

Bone Mineral Multiple Choice Questions Flashcards

1
Q

Which of the following is not an effect of vitamin D?

A. Enhanced calcium absorption
B. Enhanced gene expression
C. Enhanced calcium excretion
D. Stimulation of cell differentiation

A

C. Enhanced Calcium Excretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which of the following most likely enhanced vitamin D absorption?

A. Calcium
B. Phosphorus
C. Vitamin E
D. Fat
E. Acidic pH

A

D. Fat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which of the following is true regarding the forms of vitamin D in the body?

A. Calcidiol is the active form of vitamin D
B. Calcidiol is the main circulating form of vitamin D
C. Calcitriol bound to DBP is the main form of vitamin D in
the blood
D. Over exposure to sunlight leads to toxic levels of
cholecalciferol
E. Formation of 25(OH)D is a regulated process

A

B. Calcidiol is the main circulating form of vitamin D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which of the following population groups would you most recommend to take vitamin D supplements:

A. Lacto-ovo-vegetarians
B. Vegans
C. Older adult women
D. A & B
E. B & C

A

E. B&C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

After having had his blood levels checked, the physician confirms vitamin D deficiency. The athlete however struggles to understand why he has a low bone mass if he consumed sufficient calcium. How would you explain him the underlying mechanisms?

A. Adequate calcium intake reduces the activation of vitamin D,
which however is important for calcium reabsorption in the
kidneys.
B. Vitamin D is important for incorporation of calcium into the
bone because it stimulates the activity of osteoblasts.
C. Calcium supplements are a good source of calcium but the
absorption can be impaired in case of vitamin D deficiency.
D. Vitamin D deficiency leads to enhanced bone loss because bone
is a storage tissue for vitamin D.

A

C. Calcium supplements are a good source of calcium but the
absorption can be impaired in case of vitamin D deficiency.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

An athletic healthy 45‐year old man got a bone fracture in a sport
accident. In the x‐ray, the doctor confirmed low bone density. He is
puzzled because when reviewing his diet, he had an adequate calcium
intake from his daily supplements. He avoids dairy products given his
lactose intolerance, and follows an otherwise vegetarian diet.
What may have contributed to the low bone mass?
A. Low protein intake
B. Low dairy products
C. Calcium supplements
D. High physical activity

A

B. Low Dairy products

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Vitamin D stimulates calcium absorption through which mechanisms?

A. Stimulation of gastric acid release to digest protein‐bound
calcium
B. Stimulation of genes related to the formation of peptidases for
release of calcium from protein.
C. Stimulation of formation of transport proteins for calcium in the
intestinal lumen.
D. Stimulation of genes related to formation of proteins storing
calcium in enterocytes.

A

C. Stimulation of the formation of transport proteins for calcium in the intestinal lumen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Vitamin K is needed for the gamma carboxylation of glutamic acid residues, which promotes binding of calcium. This is
particularly important in which functions of calcium?

A. Bone mineralization
B. Nerve transmission
C. Blood clotting
D. Two of the above
E. All of the above

A

D. Two of the above

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which of the following contains the greatest amount of calcium
per 100 g?

A. Milk
B. Broccoli
C. Spinach

A

C. Spinach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

From which of the following would you absorb the most
calcium?

A. 100 g milk
B. 100 g broccoli
C. 100 g spinach

A

A. 100 g milk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Anna and Lisa (both 30 years old) make sure to drink their two cups of milk
per day for their vitamin D intake. With milk intake, they also get a large
portion of their dietary calcium.
Anna consumes her milk in form of cold high-protein milk shakes, Lisa in
form of two hot large lattes. Do they achieve the same amount of net
calcium intake with their forms of milk intake?

A. Yes, both will achieve a similar net calcium intake.
B. No, Anna will have a lower net intake because protein promotes the excretion of calcium.
C. No, Lisa will have a lower net calcium intake because coffee
increases calcium excretion.
D. No, Anna will have lower net calcium intake because the consumption of high protein inhibits calcium absorption in the
intestine.

A

C. No, Lisa will have a lower net calcium intake because coffee increases calcium excretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When calcium intakes are low (<EAR), which of the following would you expect to see?

A. Low serum calcium
B. Lower bone calcium
C. Lower intracellular calcium
D. Two of the above
E. All of the above

A

B. Lower bone calcium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which of the following is not a calcium-rich food source (comparing foods by serving size)?

A. Cow’s milk, whole
B. Broccoli
C. Almonds
D. Chicken

A

D. Chicken

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

When calcium intakes are low (<EAR), which of the following would you expect to see?

A. Deficient serum calcium concentration
B. Lower bones density
C. Inadequate intracellular calcium concentration
D. Two of the above
E. All of the above

A

B. Lower bone density

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Serum calcium concentrations are tightly regulated. Which of the following hormones promotes an increase in serum calcium?

A. PTH
B. Adrenalin
C. 25‐hydroxy‐cholecalciferol
D. Two of the above
E. All of the above

A

A. PTH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

The target organs for PTH do not include which of the following?

A. Intestine
B. Bone
C. Parathyroid glands
D. Kidney
E. Two of the above

A

E. Two of the above

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Calcium absorption is tightly regulated; thus no calcium excess is possible.

A. True
B. False

A

B. False

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Is it possible for individuals with vitamin D deficiency to have calcium excess?

  1. Yes
  2. No
A
  1. Yes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Select the statement that correctly explains the reason for why the UL is lower in older adults.

A. Older adults absorb less calcium than younger adults.
B. Younger adults have better kidney function than older adults.
C. Older adults have a higher prevalence of vitamin D deficiency.
D. Younger adults are more likely to use calcium supplements.

A

B. Younger adults have better kidney function than older adults

20
Q

Jane, 35 year female, is taking antacids for the treatment of heartburn before every meal. The antacids (tums) contain
1000mg calcium carbonate per pill. Which of the following might Jane experience from this habit?

A. Lethargy, nausea, vomiting and heart arrhythmias
B. Hyperparathyroidism
C. A and B
D. None of the above

A

D. None of the above

21
Q

Which one of the following statements is correct?

A. Food phosphorus does not require digestion because it occurs as
free inorganic form in foods.
B. Food phosphorus occurs mostly bound to lipids and requires
digestion through phosphatases.
C. Food phosphorus is absorbed freely through paracellular diffusion
and therefore does not require digestion.
D. Food phosphorus occurs mostly bound to lipids and proteins and is
therefore primarily digested with gastric acid.

A

B. Food phosphorus occurs mostly bound to lipids and requires digestion through phosphatases

22
Q

Phosphate homeostasis is regulated to maintain adequate phosphate levels. Which of the following statements is CORRECT?

A. Intestinal absorption of phosphate is regulated by high serum phosphate levels (the higher the levels, the lower the
absorption).
B. Phosphate homeostasis is regulated through intestinal absorption and urinary excretion.
C. Phosphate homeostasis is regulated by urinary excretion, i.e., in the case of excess phosphate, more phosphate is excreted.
D. Phosphate homeostasis is regulated through bone resorption and urinary excretion.

A

C. Phosphate homeostasis is regulated by urinary excretion, i.e., in the case of excess phosphate, more phosphate is excreted.

23
Q

A female 65 years old from Edmonton is referred to a dietitian after having
completed a DEXA scan and being evaluated as “high risk for osteoporosis” and
“poor bone health”. She is otherwise healthy, works at the Customer Service
Center of Air Canada, and describes to follow an overall balanced diet.
Which nutrient deficiency do you hypothesize that she most likely has?

A. Calcium & Vitamin D deficiency
B. Phosphorus & Calcium deficiency
C. Vitamin D deficiency
D. Calcium & Phosphorus & Vitamin D deficiency

A

A. Calcium & Vitamin D deficiency

24
Q

Based on your first hypothesis, what do you recommend her as next step?

A. Take vitamin D and calcium supplements twice daily
B. More frequent and longer outdoor time
C. Blood sample analyses
D. Two of the above
E. All options (A-C)

A

C. Blood sample analyses

25
Q

Her blood results confirm vitamin D deficiency. She wonders if she also may have calcium deficiency given she drastically reduced her milk consumption since hearing lots of rumor about dairy milk and cardiovascular disease risk. How likely will her calcium intake be impacted as well, when reducing milk intake?
Which scenario is most plausible?

A. Likely much lower calcium intake given calcium mostly occurs in milk in a
balanced diet.
B. She will not have had a drastic decrease if she didn’t drastically change her
meat intake.
C. If she follows a vegetarian diet, now without milk, she will have zero calcium
intake.
D. Her calcium intake may be adequate if she consumes fish and calcium rich
vegetables.

A

A. Likely much lower calcium intake given calcium mostly occurs in milk in a
balanced diet.

26
Q

Vitamin D acts like PTH in the homeostasis of calcium by increasing serum calcium
concentrations. Why does vitamin D deficiency influence bone health if the
parathyroid gland is working okay?

a. PTH does not influence urinary calcium excretion, but vitamin D does.
b. PTH reduces calcium absorption in the gut.
c. PTH promotes bone resorption.
d. Vitamin D has other target organs that PTH does not impact.

A

d. Vitamin D has other target organs that PTH does not impact.

27
Q

Why is the net effect of PTH a lowering of serum phosphate, when PTH leads to
increased bone resorption and thus release of phosphate from bone to serum?

a. PTH impacts the release of stored phosphate from bone differently than the
release of stored calcium from bone.
b. PTH inhibits the renal reabsorption of phosphate leading to an enhanced
excretion through urine.
c. PTH stimulates the formation of calcium transporters in the intestine and
thereby increases calcium absorption but not that of phosphate.
d. PTH stimulates the reabsorption of phosphate in the kidney leading to an
enhanced urinary excretion.

A

b. PTH inhibits the renal reabsorption of phosphate leading to an enhanced
excretion through urine.

28
Q

What is the effect of hypoparathyroidism?

A. Enhanced secretion of PTH
B. Vitamin D toxicity
C. Excess of phosphorus
D. Calcium adequacy

A

C. Excess of phosphorous

29
Q

Based on the functions of thyroid hormones, you would expect that a sign of iodine deficiency would be:

A. Weight loss
B. Fatigue
C. Anemia
D. Low TSH

A

B. Fatigue

30
Q

Which of the following is the richest source of naturally occurring iodine?

A. Shellfish (e.g., crab & shrimp)
B. Cow’s milk
C. Salt
D. Whole grains
E. Seaweed

A

E. Seaweed

31
Q

Deficiency of iodine would be associated with:

A. Reduced urinary excretion of iodine
B. Increased urinary excretion of iodine
C. No effect of urinary excretion of iodine
FNH

A

A. Reduced urinary excretion of iodine

32
Q

Paracellular absorption of calcium ____________.

a. requires a membrane channel protein (TRPV6)
b. occurs by diffusion mainly in the jejunum and ileum
c. increases with low dietary calcium intakes
d. requires energy and is saturable

A

b. occurs by diffusion mainly in the jejunum and ileum

33
Q

Which substance in our diet can improve calcium absorption?
a. Phosphorus
b. Lactose
c. Magnesium
d. Unabsorbed fatty acids
e. phytic acid

A

b. Lactose

34
Q

Calcium deficiency leads to:

a. increased PTH
b. increased synthesis of vitamin D in skin
c. decreased muscle contraction
d. calcification of soft tissues
e. hyperparathyroidism

A

a. increased PTH

35
Q

High calcium concentrations are sensed primarily by _______, which then secretes __________ to reduce plasma calcium.

A

High calcium concentrations are sensed primarily by the thyroid gland, which then secretes calcitonin to reduce plasma calcium.

36
Q

National Surveys have revealed that calcium intake in Canada __________.

a. have increased over time due to an increased availability of alternative milk
b. are generally quite high with most people meeting the RDA for calcium
c. have decreased over time in all age groups
d. are low in most people, except for older adults who appear to have mostly adequate intakes

A

c. have decreased over time in all groups

37
Q

Kevin lives in Hawaii. He spends most of his time outdoors but always wears sunscreen (SPF 30). He takes a vitamin D supplement daily (600 IU/15 mcg per day) and does not drink cow’s milk but consumes calcium and vitamin D fortified oat milk occasionally. His RDA is 600 IU; his UL 4,000 IU.

What would be the most appropriate advice for Kevin?

A. Take his vitamin D supplement with a meal including fat to enhance absorption.

B. Switch to cow’s milk as it provides more bioavailable vitamin D

C. Ensure that he is covered up when outdoors to prevent vitamin D toxicity.

D. Only wear sunscreen on alternate days to ensure he is getting some vitamin D from the sun

E. Decrease his supplement intake as he is likely getting too much vitamin D from his diet and the sun combined.

A

A. Take his vitamin D supplement with a meal including fat to enhance absorption.

38
Q

Vitamin D requirements are highest in older adults aged >70 years. Which one of the following statements is the correct explanation for the higher requirements?

A. Older adults need more vitamin D to maintain their bone mass.
B. Vitamin D absorption is regulated through estrogen which decreases with age.
C. There is a reduction in vitamin D formation in the skin with increasing age.
D. Older adults consume less vitamin D

A

C. There is a reduction in vitamin D formation in the skin with increasing age.

39
Q

In addition to bone health, this micronutrient is also important for acid-base balance in the body:

A. Calcium
B. Phosphorus
C. Vitamin D
D. Hydroxyapatite

A

B. Phosphorus

40
Q

Vitamin D status is assessed by measuring plasma calcidiol. This is partly because:

A. It is the functional form of vitamin D
B. It reflects both endogenous synthesis and exogenous intake of vitamin D
C. It has a very short half life in the plasma
D. Its synthesis is highly regulated
E. It is in equilibrium with tissue 1,25(OH)2D

A

B. It reflects both endogenous synthesis and exogenous intake of vitamin D

41
Q

Which of the following is true with regard to phosphorus balance?

A. Calcitriol & FGF23 have opposing effects on the levels of phosphorus in extracellular fluids
B. Calcitriol inhibits renal reabsorption of phosphorus, but FGF23 promotes renal reabsorption of phosphorus.
C. Both calcitriol & FGF23 decrease serum phosphorus levels
D. Calcitriol stimulates the release of phosphorus from bone, but FGF23 inhibits the release of P from bone.
E. Both calcitriol & FGF23 increase phosphorus absorption

A

A. Calcitriol & FGF23 have opposing effects on the levels of phosphorus in extracellular fluids

42
Q

Most phosphorus, regardless of its dietary form, is absorbed from the gastrointestinal tract:

A. Bound to lipids
B. As free inorganic phosphate ions
C. Through active transport
D. Bound to proteins
E. With calcium

A

B. As free inorganic phosphate ions

43
Q

Magnesium is essential for vitamin D to exert its function. Why? Select the correct answer:

A. Magnesium is co-factor for the enzyme that converts dietary but not endogenously formed vitamin D to 25(OH)D in the liver.
B. Magnesium is co-factor for the enzyme that converts dietary and endogenously formed vitamin D to 25(OH)D in the liver.
C. Magnesium is co-factor for the enzyme that converts vitamin D to 1,25(OH)2D in the kidney.
D. Magnesium is co-factor for the enzyme that translates the genomic action of vitamin D in the cell membrane.

A

B. Magnesium is co-factor for the enzyme that converts dietary and endogenously formed vitamin D to 25(OH)D in the liver.

44
Q

Kara is a 40-year-old woman who presents with bone pain and reduced bone mineral density.

Kara’s diet is likely low in key nutrients, however, it is unlikely that she has low intakes of:

A. Calcium
B. Vitamin D
C. Iron
D. Phosphorus

A

D. Phosphorus

45
Q

Ergocalciferol and cholecalciferol differ in:

A. Dietary sources
B. Two of the answers are correct
C. Chemical structure
D. Function
E. All of the answers are correct

A

B. Two of the answers are correct

46
Q

Which of the following statements regarding the endogenous synthesis of vitamin D is FALSE?

A. Darker skin pigment increases vitamin D synthesis
B. None of the alternatives
C. Vitamin D endogenous synthesis decreases with age
D. The use of sunscreen may reduce endogenous vitamin D synthesis

A

A. Darker skin pigment increases vitamin D synthesis

FNH 351 (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions