CCD EXAM Study Questions with
Detailed Answers Already Graded
A+ | Guarantee Pass
1. Which vertebrae should be excluded from evaluation? - ANSWER Those
that are affected by local structural change or artifact.
Those that are clearly abnormal and non-assessable within the resolution of the
system
2. How many vertebrae must be used for diagnostic classification? -
ANSWER At least two, but ideally all four will be used.
3. What if only one evaluable vertebrae remain and has low BMD, how should
diagnosis be made? - ANSWER Diagnosis must be based on a different
VALID skeletal site.
4. If there is more than a ______ T-score difference between the vertebrae in
question and adjacent vertebrae, exclude the vertebrae in question from
analysis. - ANSWER 1.0
5. When vertebrae are excluded, what is used to derive the T-score? -
ANSWER the BMD of the remaining vertebrae
6. The lateral spine only has a role in __________________ and should not be
used for ____________________. - ANSWER monitoring
diagnosis
,7. BMD must be measured in which hip? - ANSWER Either hip will suffice
8. Can mean T-scores for bilateral hip BMD be used for diagnosis? -
ANSWER Insufficient data exists.
- ANSWER Which hip regions of interest should be used for diagnosis?
1) Femoral neck
2) Total proximal femur
Whichever is lower
9. When using the forearm for diagnosis, what is the region of interest? -
ANSWER 33% radius of the non-dominant forearm
10.Are the use of BMD for diagnosing osteoporosis and for assessing fracture
risk the same thing? - ANSWER No
11.What can be used for fracture risk assessment? - ANSWER Any well-
validated technique can be used, including measurements of more than one
site where this has been shown to improve the assessment of risk.
12.Which terms are preferred to the term "osteopenia"? - ANSWER "low bone
mass" or "low bone density"
13.Are people with low bone mass or density at a high risk for fracture? -
ANSWER Not necessarily.
,14.Which scores should be used to reported in post-menopausal women and in
men aged 50 and older? - ANSWER T-scores
15.Which scores should be used to reported in pre-menopausal women and in
men younger than age 50? - ANSWER Z-scores - especially important in
children
16.A Z-score of -2.0 or lower is - ANSWER "below the expected range for
age"
17.A Z-score above -2.0 is - ANSWER "within the expected range for age."
18.Osteoporosis cannot be diagnosed in which cohort on the basis of BMD
alone? - ANSWER Men under age 50
19.Z-scores differ from T-scores in that Z-scores . . . - ANSWER should be
population specific where adequate reference data exist.
20.How soon after initiation or change of therapy is BMD testing typically
repeated? - ANSWER One year
21.Indications for serial BMD testing: - ANSWER 1) To determine whether
treatment should be started on untreated patients because significant loss
may be an indication for treatment
2) To monitor response to therapy by finding an increase or stability of bone
density.
, 3) To evaluate individuals for non-response by finding loss of bone density,
suggesting the need for reevaluation of treatment and evaluation for secondary
causes of osteoporosis.
22.Follow-up BMD testing should be done when the expected change in BMD
equals or exceeds what? - ANSWER The least significant change (LSC)
23.When is testing more frequently appropriate? - ANSWER In conditions
associated with rapid bone loss, such as glucocorticoid therapy.
24.As part of a QC program, how often should a DXA facility perform phantom
scans as an independent assessment of system calibration? - ANSWER At
least once per week
25.These QC procedures are advised for any DXA facility: - ANSWER 1)
Performance of periodic phantom scans (at least once weekly)
2) Plot and review data from calibration and phantom scans.
3) Verify the phantom mean BMD after any service performed on the
densitometer.
4) Establish and enforce corrective action thresholds that trigger a call for
service
5) Maintain service logs.
6) Comply with government inspections, radiation surveys and regulatory
requirements.
Detailed Answers Already Graded
A+ | Guarantee Pass
1. Which vertebrae should be excluded from evaluation? - ANSWER Those
that are affected by local structural change or artifact.
Those that are clearly abnormal and non-assessable within the resolution of the
system
2. How many vertebrae must be used for diagnostic classification? -
ANSWER At least two, but ideally all four will be used.
3. What if only one evaluable vertebrae remain and has low BMD, how should
diagnosis be made? - ANSWER Diagnosis must be based on a different
VALID skeletal site.
4. If there is more than a ______ T-score difference between the vertebrae in
question and adjacent vertebrae, exclude the vertebrae in question from
analysis. - ANSWER 1.0
5. When vertebrae are excluded, what is used to derive the T-score? -
ANSWER the BMD of the remaining vertebrae
6. The lateral spine only has a role in __________________ and should not be
used for ____________________. - ANSWER monitoring
diagnosis
,7. BMD must be measured in which hip? - ANSWER Either hip will suffice
8. Can mean T-scores for bilateral hip BMD be used for diagnosis? -
ANSWER Insufficient data exists.
- ANSWER Which hip regions of interest should be used for diagnosis?
1) Femoral neck
2) Total proximal femur
Whichever is lower
9. When using the forearm for diagnosis, what is the region of interest? -
ANSWER 33% radius of the non-dominant forearm
10.Are the use of BMD for diagnosing osteoporosis and for assessing fracture
risk the same thing? - ANSWER No
11.What can be used for fracture risk assessment? - ANSWER Any well-
validated technique can be used, including measurements of more than one
site where this has been shown to improve the assessment of risk.
12.Which terms are preferred to the term "osteopenia"? - ANSWER "low bone
mass" or "low bone density"
13.Are people with low bone mass or density at a high risk for fracture? -
ANSWER Not necessarily.
,14.Which scores should be used to reported in post-menopausal women and in
men aged 50 and older? - ANSWER T-scores
15.Which scores should be used to reported in pre-menopausal women and in
men younger than age 50? - ANSWER Z-scores - especially important in
children
16.A Z-score of -2.0 or lower is - ANSWER "below the expected range for
age"
17.A Z-score above -2.0 is - ANSWER "within the expected range for age."
18.Osteoporosis cannot be diagnosed in which cohort on the basis of BMD
alone? - ANSWER Men under age 50
19.Z-scores differ from T-scores in that Z-scores . . . - ANSWER should be
population specific where adequate reference data exist.
20.How soon after initiation or change of therapy is BMD testing typically
repeated? - ANSWER One year
21.Indications for serial BMD testing: - ANSWER 1) To determine whether
treatment should be started on untreated patients because significant loss
may be an indication for treatment
2) To monitor response to therapy by finding an increase or stability of bone
density.
, 3) To evaluate individuals for non-response by finding loss of bone density,
suggesting the need for reevaluation of treatment and evaluation for secondary
causes of osteoporosis.
22.Follow-up BMD testing should be done when the expected change in BMD
equals or exceeds what? - ANSWER The least significant change (LSC)
23.When is testing more frequently appropriate? - ANSWER In conditions
associated with rapid bone loss, such as glucocorticoid therapy.
24.As part of a QC program, how often should a DXA facility perform phantom
scans as an independent assessment of system calibration? - ANSWER At
least once per week
25.These QC procedures are advised for any DXA facility: - ANSWER 1)
Performance of periodic phantom scans (at least once weekly)
2) Plot and review data from calibration and phantom scans.
3) Verify the phantom mean BMD after any service performed on the
densitometer.
4) Establish and enforce corrective action thresholds that trigger a call for
service
5) Maintain service logs.
6) Comply with government inspections, radiation surveys and regulatory
requirements.
