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dexa 2
John Appleseed9305
Quiz by John Appleseed9305, updated more than 1 year ago
John Appleseed9305
Created by John Appleseed9305 over 8 years ago
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Resource summary

Question 1

Question
According to WHO, for the diagnosis of osteoporosis, based on the measurement of bone density is:
Answer
  • 2.5 SDs or more below the young adult peak bone density and a fracture
  • 2.5 SDs or more below the young adult peak bone density
  • More than 1 SD but less than 2.5 SDs below the young adult peak bone density
  • Not more than 1 SD below the young adult peak bone density

Question 2

Question
What is the most common technique that is used to measure BMD?
Answer
  • QUS
  • QCT
  • SXA
  • DXA

Question 3

Question
What is the most common osteoporotic fracture?
Answer
  • Hip
  • Shoulder
  • Spine
  • Wrist

Question 4

Question
In bone densitometry, what is the primary responsibility of the technologist?
Answer
  • beam collimation
  • distance
  • shielding
  • time

Question 5

Question
Which of the following is considered an uncontrollable risk factor for osteoporosis?
Answer
  • exercise
  • lifestyle choices
  • smoking
  • race

Question 6

Question
Which of the following measures more trabecular bone?
Answer
  • PA spine
  • Lateral spine
  • QCT spine
  • VFA

Question 7

Question
Primary osteoporosis Type 1, is related to
Answer
  • aging
  • disease
  • medication
  • menopause

Question 8

Question
Identify the incorrect statement from the following:
Answer
  • Caucasian and Asians are at an increase risk of developing osteoporosis compared to other ethnic groups
  • most obese patients are at an increase risk of developing osteoporosis
  • women are at an increase risk of developing osteoporosis compared to men because they achieve a lower peak bone mass and go through menopause
  • smoking is a recognized risk factor for the development of osteoporosis

Question 9

Question
Cancellous bone is also known as :
Answer
  • compact bone
  • cortical bone
  • trabecular bone
  • osteophyte

Question 10

Question
New bone matrix is formed by:
Answer
  • osteoblasts
  • osteoclasts
  • cortical bone
  • cancellous bone

Question 11

Question
What percentage of trabecular bone is found in the PA spine?
Answer
  • 1%
  • 33%
  • 50%
  • 66%

Question 12

Question
Currently, the most accurate method to determine a patient’s response to therapy form osteoporosis is:
Answer
  • serial DXA measurements of the forearm
  • serial DXA measurements of the hip and spine
  • serial QUS measurements of the calcareous
  • Serial QCT measurements of the spine

Question 13

Question
Which of the following does not help in achieving peak bone mass?
Answer
  • normal puberty
  • exercise
  • corticosteroid therapy
  • adequate calcium and vitamin D intake

Question 14

Question
Which of the following statement is false concerning QUS advantages over x-ray base methodologies for BMD measurements?
Answer
  • QUS units are comparatively inexpensive
  • the patients heel must be immersed in liquid during the procedure
  • patients are not subjected to ionizing radiation
  • ultrasound examinations are quick to perform

Question 15

Question
which of following site is mostly composed of cortical bone
Answer
  • distal forearm
  • femoral neck
  • proximal forearm
  • vertebral bodies

Question 16

Question
What is the anatomical landmark on the proximal femur that indicates the best visual indication of the degree of rotation of the proximal femur?
Answer
  • femoral head
  • femoral shaft
  • greater trochanter
  • lesser trochanter

Question 17

Question
Which lumbar vertebra is described as having a characteristic shape of an X or H on a DXA PA spine scan?
Answer
  • L1
  • L2
  • L3
  • L4

Question 18

Question
What is the name of the radionuclitide used in DPA?
Answer
  • Americium- 241
  • Gadolinium-153
  • Iodine‘-125
  • Technetium-99

Question 19

Question
The forearm is not used to monitor the effects of therapy for osteoporosis because
Answer
  • accuracy is poor
  • precision is poor
  • there is no effect
  • the rate of change in BMD is to slow

Question 20

Question
Which of the following is not a bisphosphonate?
Answer
  • alendronate
  • etodronate
  • foiteo
  • zoledronic acid

Question 21

Question
The primary mechanism of action of anti-resorptive therapies is the result of direct interaction with:
Answer
  • the bone lining cells
  • the osteoblasts
  • the osteoclasts
  • the osteocytes

Question 22

Question
The WHO criteria for diagnosing osteoporosis was initially defined to apply to
Answer
  • all women
  • all Caucasian women
  • only postmenopausal women
  • only Caucasian postmenopausal women

Question 23

Question
The measurement of peripheral BMD is advocated for
Answer
  • all individuals regardless of age
  • pediatrics
  • screening
  • males

Question 24

Question
The PA spine mostly measures the:
Answer
  • posterior elements
  • vertebral bodies
  • transverse processes
  • pedicle

Question 25

Question
Which of the following statement about QCT measurements of bone density of the spine is not True?
Answer
  • the measurements are volumetric rather than areal measurements of bone density
  • accuracy may be affected by marrow fat
  • results are usually reported in g/cm squared
  • trabecular bone can be isolated from cortical bone

Question 26

Question
ln order to do a compare analysis:
Answer
  • the patient must have a previous scan done on the same mode/speed
  • you must retrieve the baseline scan(s)
  • patient positioning must be consistent
  • all of the above

Question 27

Question
How many degrees should you rotate the femur when positioning for a proximal femur scan?
Answer
  • 10 -15 degrees
  • 15-25 degrees
  • 20-25 degrees
  • 25-30 degrees

Question 28

Question
When should Z-scores be used to make a diagnosis, instead of T-scores?
Answer
  • females 65 and older
  • males 65 and older
  • postmenopausal females
  • males or females under age 20

Question 29

Question
Which of the following bone parameters is measured in grams?
Answer
  • area
  • bone mineral content
  • bone mineral density
  • total

Question 30

Question
Which lumbar vertebra has the widest transverse process?
Answer
  • L1
  • L2
  • L3
  • L4

Question 31

Question
The region of the proximal femur lying on the border of the femoral neck is termed:
Answer
  • lesser trochanter
  • femoral head
  • hip axis length
  • ward's area

Question 32

Question
What is important for serial monitoring?
Answer
  • accuracy
  • precision

Question 33

Question
If the daily QC fails, (in the United States) what should be your first step of action?
Answer
  • repeat the scan
  • call the manufacturer
  • get yourself another cup of coffee
  • go home!

Question 34

Question
With changes in rotation of the femoral neck what happens?
Answer
  • decrease in the BMC
  • decrease in the BMD
  • increase in the BMD
  • increase ROI

Question 35

Question
Which of the following would best describe low bone mass due to menopause?
Answer
  • primary osteoporosis/Type 1
  • primary osteoporosis/Type 11
  • secondary osteoporosis

Question 36

Question
According to WHO, if a healthy female age 36 (female with no known medical condition present, all body parts working perfecting) has a T-score of 1 6 SD how would she be diagnosed?
Answer
  • normal
  • osteopenia
  • osteoporosis
  • none of the above

Question 37

Question
Which of the following term best describes the sum of data values divided by the number of values?
Answer
  • the mean
  • the standard deviation
  • the variance
  • the coefficient

Question 38

Question
How many decimal places to the right of the decimal point is used in reporting the T-scores?
Answer
  • 0
  • 1
  • 2
  • 3

Question 39

Question
At low energies the majority of x-ray interactions are:
Answer
  • Compton scattering
  • photoelectric
  • photodisintegration
  • pair production

Question 40

Question
What concept should always guide radiation protection effects?
Answer
  • time
  • distance
  • shielding
  • ALARA

Question 41

Question
If a patient has a history of hyper-parathyroidism, which of the following would be the preferred site to evaluate ?
Answer
  • proximal femur
  • spine
  • ultradistal
  • 33% or 1/3 forearm

Question 42

Question
Which of the following classes of cells are involved in bone remodeling?
Answer
  • osteoblasts
  • osteoclasts
  • osteocytes
  • a and b
  • all of the above

Question 43

Question
Which of the following has the highest percentage of cortical bone?
Answer
  • femoral neck
  • fingers
  • whole body
  • 33% radius

Question 44

Question
Which of the following bone parameters is measured in grams per centimeter squared?
Answer
  • area
  • BMC
  • BMD
  • BMMA

Question 45

Question
What is the percentage of trabecular bone in the skeleton?
Answer
  • 20%
  • 30%
  • 70%
  • 80%

Question 46

Question
How would start labeling the vertebral bodies on a PA lumbar scan?
Answer
  • Let the software do it all!
  • start at L1, and count/label down
  • start at L4, and count/label up

Question 47

Question
What is the major source of precision error in clinical practice?
Answer
  • equipment
  • physician
  • technologist
  • receptionist

Question 48

Question
Which of the following is correct?
Answer
  • BMD=BMC/Area
  • BMD=BMCxArea

Question 49

Question
During analyzes of the lumbar spine, what would help you identify the vertebral bodies?
Answer
  • read the manual
  • look for L3 ( longest transverse process)
  • their characteristic shapes
  • all of the above

Question 50

Question
A great forearm scan should include all of the following except:
Answer
  • forearm centered
  • forearm straight
  • free of artifacts
  • motion

Question 51

Question
Sunlight is the main source of vitamin:
Answer
  • A
  • C
  • D
  • K

Question 52

Question
Bisphosphonates prevent bone loss by:
Answer
  • reducing the activity of the osteoclasts
  • increasing the activity of the osteoblasts
  • increasing the activity of the osteoclasts

Question 53

Question
DXA results may be influenced by:
Answer
  • body thickness
  • degenerative changes
  • fractures
  • scan mode
  • all of the above

Question 54

Question
Which of the following would best describe the effective dose for a central DXA scan?
Answer
  • one-tenth of a chest x-ray
  • less than a day of background radiation
  • less than a round trip from Boston to LA
  • all of the above

Question 55

Question
When measuring the proximal femur, which of the following statements is true?
Answer
  • the neck ROI includes any portion of the greater trochanter
  • the neck ROI is perpendicular to the femoral neck
  • the neck ROI includes both ends in bone
  • I need to read the manual!!

Question 56

Question
Which of the following statements is true regarding DXA?
Answer
  • DXA has been widely studied and requires a radioactive source
  • DXA is faster than DPA but is not as precise
  • DXA can only predict fracture risk of the hip and spine
  • DXA can be used to predict fracture risk and to evaluate the effectiveness of treatment

Question 57

Question
How often should you perform the QA on the DXA unit?
Answer
  • once a week
  • once a year
  • every day you scan
  • only when you get a message on your monitor

Question 58

Question
Why is the non-dominant arm used in bone densitometry?
Answer
  • easier for the patient
  • easier for the technologist
  • its density values will be greater than that of the dominant arm
  • reference values reflect non-dominant arm measurements

Question 59

Question
If a patients BMC is 60.58 and the area is 61.60 what is her BMD?
Answer
  • 0.983
  • 1.01

Question 60

Question
All of the following are true, except:
Answer
  • accuracy is the ability to measure true value
  • accuracy is most important for diagnosis, less important for serial monitoring
  • accuracy is affected by the technologist
  • accuracy is affected by the technology

Question 61

Question
What is the distance a technologist should be away from the edge of the DXA table with a pencil beam scanner?
Answer
  • 2 feet
  • 3 feet
  • 4 feet
  • 10 feet

Question 62

Question
What is the most common osteoporotic fracture?
Answer
  • heel
  • hip
  • spine
  • wrist

Question 63

Question
Two bones with the same volumetric densities may have different densities when measured with DXA because:
Answer
  • poor precision
  • poor accuracy
  • differ in size
  • degenerative changes

Question 64

Question
Regarding the Shewart Rules, the control limits are based on what percentage of the average values?
Answer
  • 0.5%
  • 1%
  • 1.5%
  • 2%

Question 65

Question
All follow-up DXA scans should be compared to:
Answer
  • any prior scan
  • the most recent scan
  • the baseline scan
  • Operator’s choice!

Question 66

Question
With DXA, regarding the PA spine, which vertebra is expected to have the lowest bone mineral density?
Answer
  • L1
  • L2
  • L3
  • L4

Question 67

Question
A DXA scanner that uses a single detector and a pinhole collimator is:
Answer
  • a fan beam scanner
  • a pencil beam scanner
  • an aerial beam scanner

Question 68

Question
The characteristic shapes of the vertebrae seen on the spine DXA image are primarily based on the appearance of the:
Answer
  • transverse processes
  • vertebral bodies
  • posterior elements of the vertebra
  • intervertebral discs

Question 69

Question
When scanning the proximal femur, what is the anatomical landmark to look at if you have correct rotation?
Answer
  • the femoral head
  • the greater trochanter
  • the lesser trochanter
  • the ischium

Question 70

Question
To determine the least significant change at 95% confidence level (for baseline and one follow-up scan), what is the "number" which the precision error is multiplied to determine the least significant change?
Answer
  • 2.77
  • 1.96
  • 1.81
  • 1.28

Question 71

Question
A technologist should perform a precision study in order to:
Answer
  • quantify the shifts and drifts(QA)
  • calculate the LSC
  • To see how great you are!
  • To see how great your doc is doing!

Question 72

Question
How many places to the right of the decimal point is used in reporting BMD?
Answer
  • 0
  • 1
  • 2
  • 3

Question 73

Question
The name of the forearm sites is based on what?
Answer
  • the location of the site on the bone in relationship to the overall length of the radius
  • the location of the site on the bone in relationship to the overall length of the ulna
  • % of cortical bone found at that site
  • % of trabecular bone found at that site

Question 74

Question
What skeletal site may be preferred for assessing early menopause or following oophorectomy?
Answer
  • Calcaneus
  • Forearm
  • Hip
  • spine

Question 75

Question
When analyzing the PA spine, which of the following is a "no can do?
Answer
  • Spine straight and centered within the ROI
  • The top line of the ROI positioned between T12 and L1
  • The bottom of the line of the ROI positioned between L4 and L5
  • Width is operator’s choice

Question 76

Question
If you are very fortunate, and you get a new DXA unit, what must be performed in order to do compare studies?
Answer
  • establish QC program
  • cross-calibration

Question 77

Question
All of the following are examples of weight-bearing exercise except:
Answer
  • running
  • dancing
  • racket sports
  • lap swimming

Question 78

Question
What type of bone with long term use of steroids affect?
Answer
  • trabecular
  • cancellous
  • Cortical
  • Compact
  • a and b
  • b and c
  • c and d

Question 79

Question
If a patient has had an Iaminectomy, how would that affect the results?
Answer
  • increase BMD
  • decrease BMD
  • nothing at all

Question 80

Question
What are the two most common methods for shifting the energies in DXA units?
Answer
  • energy switching
  • K-edge filtration
  • Compton effect
  • photoelectric effect

Question 81

Question
Why do you use a leg block, when performing a PA spine DXA scan? Select all that appy.
Answer
  • reduce Iordotic curve
  • separate the verebrae
  • may feel good to the patient
  • Operator’s manual said so!

Question 82

Question
What is the term often used to express the precision of the DXA unit?
Answer
  • mean
  • standard deviation
  • linear regression

Question 83

Question
Why do you use a “hip positioner", during scanning of the proximal femur?
Answer
  • to place the femoral neck parallel to the tabletop
  • to place the ward's area in the correct location
  • to obtain the total hip results
  • because you have it!

Question 84

Question
lf a patients is found to have coins in their pocket while obtaining the proximal femur what should you do.
Answer
  • scan the other hip
  • scan the forearm
  • remove the coins and rescan the hip
  • remove the coins and keep them!

Question 85

Question
A patient with an elevated alkaline phosphatase may be an indicator of
Answer
  • osteoporosis
  • osteomalacia
  • osteopetrosis
  • Pagets

Question 86

Question
What is the percentage of cortical bone (compact bone) in the skeleton?
Answer
  • 20%
  • 30%
  • 70%
  • 80%

Question 87

Question
What angle should the patient's leg be positioned on the leg block for the PA spine?
Answer
  • 30-60 degrees
  • 40-60 degrees
  • 60-80 degrees
  • 60-90 degrees

Question 88

Question
What year was the Bone Mass Measurement Act proposed?
Answer
  • 1991
  • 1993
  • 1997
  • 1998

Question 89

Question
What pharmaceutical may be suggested for a woman with high risk of breast cancer and elevated lipids?
Answer
  • Actonel
  • Evista
  • Fosamax
  • Prolia

Question 90

Question
In bone densitometry, what describes the ability to reproduce the measurement when it is performed under identical conditions?
Answer
  • absolute risk
  • accuracy
  • precision
  • relative risk

Question 91

Question
Decide which of the following is the most important factor to consider when performing a DXA scan?
Answer
  • make sure pt is comfortable
  • make sure patient removes items that may attenuate the beam
  • make sure patient is NPO
  • make sure that you have the correct patient!

Question 92

Question
How can a patient be deprived of vitamin D?
Answer
  • reduction in dietary intake
  • malabsorption of fats
  • not exposed to sunlight
  • all of the above

Question 93

Question
Which of the following calcium supplements should be the choice for women who are at risk of kidney stone formation?
Answer
  • calcium carbonate
  • calcium citrate
  • calcium gluconate
  • calcium lactate

Question 94

Question
The correct way to measure radiation dose is as effective dose, expressed as:
Answer
  • uGy
  • uSv
  • uCi
  • rad

Question 95

Question
All of the following are risk factors for 733 except:
Answer
  • smoking
  • drinking 48 ounces of coffee a day
  • alcohol use
  • obesity

Question 96

Question
QUS what is the gold standard to measure bone density?
Answer
  • DPA
  • DXA
  • QCT
  • QUS

Question 97

Question
Cortical bone makes up what?
Answer
  • the inner core of the bones
  • the outer core of the bones

Question 98

Question
All of the following are correct except:
Answer
  • osteoporosis is usually asymptomatic
  • back pain and height loss may be the first signs of osteoporosis
  • kyphosis is common in patients with osteoporosis
  • African Americans are at higher risk to develop osteoporotic in comparison to Asians

Question 99

Question
What are the four classifications that apply to the heel?
Answer
  • appendicular, predominately trabecular and weight-bearing
  • axial, peripheral, predominantly cortical and non weight-bearing

Question 100

Question
Secondary osteoporosis is defined as:
Answer
  • bone loss caused by factors other than estrogen deficiency
  • bone loss caused by factors other than aging
  • bone loss caused by factors other than estrogen deficiency and aging
  • none of the above

Question 101

Question
The forearm, pelvis, and scapula all belong to which skeletal classification?
Answer
  • appendicular
  • axial
  • central
  • weight-bearing
  • a and b

Question 102

Question
When there is an imbalance/uncoupling of the remodeling cycle, the result is
Answer
  • an increase in the calcium
  • a decrease in the resorption
  • a net gain in the bone mass
  • a net loss in the bone mass

Question 103

Question
During a DXA of the hip of a thin patient, a mottled or moth eaten appearance at the edge is seen, what may be helpful to correct this?
Answer
  • use a higher speed setting
  • use a slower speed setting
  • can another site
  • get the next patient!

Question 104

Question
What is the bone edge detection methodology?
Answer
  • it tests the machine's ability to measure BMD
  • it tests the machine's ability to distinguish bone from soft tissue
  • it verifies the machine is calibrated correctly

Question 105

Question
What sites are preferred for children?
Answer
  • Iumbar spine and hip(s)
  • lumbar spine, hip, and forearm
  • lumbar spine and TBLH
  • lumbar spine only

Question 106

Question
In making a diagnosis for children, what are some guidelines? Select all that apply.
Answer
  • Z--scores are used
  • low for age is preferred over the term osteopenia
  • pediatric software is highly recommended
  • osteoporosis can be made with a Z-score of -2.5 SD

Question 107

Question
What is the only anabolic pharmaceutical on the market for treatment of osteoporosis?
Answer
  • calcitonin
  • zoledronic acid
  • aloxifene
  • teriparatide

Question 108

Question
Although the technology is similar with all the DXA units, the BMD results are different because...select all that apply.
Answer
  • due to different calibration standards
  • algorithms to calculate BMD
  • differences in the region of interest
  • databases
  • All of the above

Question 109

Question
For low energies, the most common process of absorption is the:
Answer
  • Compton effect
  • pair production
  • photoelectric effect
  • photodisintegration

Question 110

Question
How many patients and how many times do you scan them in order to perform a precision study? Select all that apply.
Answer
  • 10 patients 3 times
  • 15 patients 3 times
  • 20 patients 2 times
  • 30 patients 2 times

Question 111

Question
Phantoms that mimic the shape and size of a skeletal region are called:
Answer
  • block phantom
  • brass phantom
  • anthromomorphic phantom
  • hydroxyaptite

Question 112

Question
If the QC graph shows a gradual decline in BMD overtime, what should you do?
Answer
  • repeat the QC
  • Re-establish a baseline value
  • call the manufacturer for service
  • upgrade your unit

Question 113

Question
Regarding bone densitometry, which of the following best describes accuracy?
Answer
  • the degree to which the measurement of BD reflects true value
  • the degree to which the QC reflects true value
  • the degree to which the %CV reflects true value

Question 114

Question
Which of the following are clinical signs and consequences of vertebral fractures? Select all that apply.
Answer
  • kyphosis
  • weight loss
  • reduced lung function
  • increase in height

Question 115

Question
All of the following are markers of bone formation, except?
Answer
  • 24-hour excretion rate of calcium
  • serum alkaline phosphatase
  • serum osteocalcin

Question 116

Question
Pencil beam DXA units usually have shorter scanning times and better resolution compared to fan beam units.
Answer
  • True
  • False

Question 117

Question
Quantitative ultrasonometry measures the broad band attenuation properties of bone.
Answer
  • True
  • False

Question 118

Question
The correct term for the scanning pattern of a pencil beam unit is rectilinear.
Answer
  • True
  • False

Question 119

Question
Archiving patient’s scans and running the system back-up are one in the same.
Answer
  • True
  • False

Question 120

Question
The weight Iimit for the DXA table is manufacturer specific?
Answer
  • True
  • False

Question 121

Question
When analyzing the proximal femur the box measuring the neck should include the greater trochanter.
Answer
  • True
  • False

Question 122

Question
In regards to the International society for Clinical Densitometry 2013 Official Positions, Osteoporosis cannot be diagnosed in men under the age 50 on the basis of BMD alone.
Answer
  • True
  • False

Question 123

Question
Cortical bone is also known as cancellous bone.
Answer
  • True
  • False

Question 124

Question
With fan beam scanners, scanning occurs point by point.
Answer
  • True
  • False

Question 125

Question
Discordance is a term that is rarely used in DXA.
Answer
  • True
  • False

Question 126

Question
The smaller the %CV, the better the accuracy and precision.
Answer
  • True
  • False

Question 127

Question
Rheumatoid arthritis can contribute to the development of osteoporosis.
Answer
  • True
  • False

Question 128

Question
Bone loss occurs when resorption exceeds formation.
Answer
  • True
  • False

Question 129

Question
T-scores are useful for the expression of relative risk.
Answer
  • True
  • False

Question 130

Question
T-scores should be used in serial monitoring.
Answer
  • True
  • False

Question 131

Question
Sievert refers to effective dose.
Answer
  • True
  • False

Question 132

Question
The measure of the variability or the spread of data around the mean is termed standard deviation.
Answer
  • True
  • False

Question 133

Question
Accuracy is most important for diagnosis, less important for serial monitoring.
Answer
  • True
  • False

Question 134

Question
The ultra distal part of the forearm is mostly trabecular bone.
Answer
  • True
  • False

Question 135

Question
With VFA, you are measuring the BMD L4 through T4.
Answer
  • True
  • False

Question 136

Question
Cortical bone is primarily affected with an estrogen deficient woman.
Answer
  • True
  • False

Question 137

Question
Precision is the ability to reproduce a measurement when performed under identical conditions.
Answer
  • True
  • False

Question 138

Question
When a patient comes back for a follow-up scan, it's no problem if you don't use the compare/copy function.
Answer
  • True
  • False

Question 139

Question
The Tanner and Whitehouse (TW2) method is often used to indicate bone age in children.
Answer
  • True
  • False

Question 140

Question
The T-score is the number of SDs an individual’s BMD is from the average BMD for sex-matched young normal peak bone mass.
Answer
  • True
  • False

Question 141

Question
Caucasians and Asians are at increased risk to developing osteoporosis compared to otherethnic groups.
Answer
  • True
  • False

Question 142

Question
Smoking is not recognized as a risk factor for the development of osteoporosis.
Answer
  • True
  • False

Question 143

Question
With fan beam scanners a solid state/multi element array detector system is used.
Answer
  • True
  • False

Question 144

Question
DXA BMD measures the amount of mineralized tissue in the area scanned. (g/cm3)
Answer
  • True
  • False

Question 145

Question
Accuracy indicates how close a measured value is to the actual value.
Answer
  • True
  • False
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