MNLP – Module 9 – Final assessment

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Question 1 of 20

1. Question
4 point(s)
Insert the appropriate word into the sentence

Word choice: Osteoblasts, osteoclasts, resorption, formation
- The process of bone remodelling involves two distinct phases: during which break down bone and when lay down new bone.
Correct

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Question 2 of 20

2. Question
1 point(s)
Which cytokine system is thought to be the main osteoclast activator that causes myeloma bone disease?
- A. TGF-beta superfamily
- B. IL-6 family
- C. RANKL-OPG family
- D. Wnt family
- E. IL-1 family
Correct

Incorrect
Question 3 of 20

3. Question
1 point(s)
Approximately what percentage of patients are affected by myeloma bone disease at the time of diagnosis?
- A. 20%
- B. 40%
- C. 70%
- D. 80%
- E. 90%
Correct

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Question 4 of 20

4. Question
1 point(s)
Which of the following is not considered to be a common clinical consequence of myeloma bone disease?
- A. Hyperkalaemia
- B. Bone pain
- C. Pathological fracture
- D. Kyphosis
- E. Spinal cord compression
Correct

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Question 5 of 20

5. Question
1 point(s)
Which of the following treatments can be used to treat myeloma bone pain?
- A. Percutaneous Vertebroplasty
- B. Balloon Kyphoplasty
- C. Systemic analgesia
- D. Bisphosphonates
- E. All of the above
Correct

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Question 6 of 20

6. Question
1 point(s)
A patient presenting with radicular pain, loss of bladder control, loss of sensation and difficulty walking is showing symptoms of
- A. Hypercalcaemia
- B. Fracture of the pelvis
- C. Kyphosis
- D. Vertebral collapse
- E. Spinal cord compression
Correct

Incorrect

Question 7 of 20

7. Question

3 point(s)

Match the following imaging techniques to the description

Drag and drop your answers

Sort elements

PET scan
CT scan
MRI scan

A nuclear imaging technique involving the administration of a radiotracer

Specialised X-rays which create cross sectional images of the body

Uses magnetic energy to produce 2D and 3D images of organs and tissues

Correct

Incorrect

Question 8 of 20

8. Question
1 point(s)
How many bisphosphonates are licensed for use in myeloma in the UK?
- A. 1
- B. 2
- C. 3
- D. 4
- E. None
Correct

Incorrect
Question 9 of 20

9. Question
1 point(s)
Is the following statement true or false?

Myeloma patients are advised to have a dental examination before starting bisphosphonate treatment
- A. True
- B. False
Correct

Incorrect
Question 10 of 20

10. Question
1 point(s)
Which of the following statement about Percutaneous Vertebroplasty is true?
- A. Restores vertebral height
- B. Involves the percutaneous injection of a polymer bone cement into a collapsed vertebra
- C. Involves the insertion of an inflatable bone tamp into a fractured vertebra
- D. Requires a lengthy stay in hospital
- E. Procedure of choice for fractured vertebrae
Correct

Incorrect
Question 11 of 20

11. Question
1 point(s)
Which of the following is not particularly useful for relieving neuropathic pain caused by spinal cord compression?
- A. Gabapentin
- B. Duloxetine
- C. Pregabalin
- D. Tramadol
- E. Amitriptyline
Correct

Incorrect
Question 12 of 20

12. Question
1 point(s)
Osteonecrosis of the jaw is a rare but potentially serious side-effect of bisphosphonate treatment that can develop after
- A. Dental extraction
- B. Dental filling
- C. Rigorous brushing or flossing that causes bleeding gums
- D. Bridging work
- E. Tooth polishing
Correct

Incorrect
Question 13 of 20

13. Question
1 point(s)
Which bisphosphonate is the treatment of choice after results of the Myeloma IX trial showed that it not only reduced the number of skeletal related events but also offered a survival advantage?
- A. Sodium clodronate
- B. Disodium pamidronate
- C. Zoledronic acid
- D. Alendronic acid
- E. Sodium risedronate
Correct

Incorrect
Question 14 of 20

14. Question
1 point(s)
Assertion: Localised radiotherapy is ineffective for treating painful or structurally damaging lytic lesions

BECAUSE

Reason: Radiotherapy can initially increase pain in the area being treated
- A. True True – reason correctly explains assertion
- B. True True – both statements are true but the reason does not explain the assertion
- C. True False
- D. False True
- E. False False
Correct

Incorrect
Question 15 of 20

15. Question
1 point(s)
Several non-medical interventions may help relieve pain caused by myeloma bone disease. Which of the following is not a recognised method?
- A. Transcutaneous electrical nerve stimulation
- B. Chiropractic treatment
- C. Orthopaedic bracing
- D. Application of hot/cold compression packs
- E. Relaxation techniques such as meditation and visualisation
Correct

Incorrect
Question 16 of 20

16. Question
1 point(s)
Assertion: Normal bone remodelling keeps bone in a state of constant renewal throughout life

BECAUSE

Reason: Bone remodelling plays an important role in maintaining plasma calcium homeostasis
- A. True True – reason correctly explains assertion
- B. True True – both statements are true but the reason does not explain the assertion
- C. True False
- D. False True
- E. False False
Correct

Incorrect
Question 17 of 20

17. Question
1 point(s)
Myeloma bone disease can affect any bone in the body
- A. True
- B. False
Correct

Incorrect
Question 18 of 20

18. Question
1 point(s)
For myeloma patients with bone disease, a cough or a sneeze can fracture a damaged bone
- A. True
- B. False
Correct

Incorrect
Question 19 of 20

19. Question
1 point(s)
Which of the following imaging techniques is useful for evaluating a vertebral tumour mass and confirming suspected spinal cord compression?
- A. X-ray
- B. CT scan
- C. MRI scan
- D. PET scan
- E. PET-CT scan
Correct

Incorrect
Question 20 of 20

20. Question
1 point(s)
The most appropriate way to manage a myeloma patient presenting with severe hypercalcaemia is to
- A. Treat with the monoclonal antibody denosumab
- B. Reduce dietary calcium and vitamin D intake
- C. Administer calcitonin
- D. Administer intravenous bisphosphonate
- E. None of the above
Correct

Incorrect

MNLP – Module 9 – Final assessment