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Zorluk: KolayPreventive Care and Screening

A 65-year-old woman schedules a telehealth consultation to establish primary care after moving to a new state. She reports feeling well and takes only a daily multivitamin. She underwent menopause at age 51. She has never used tobacco products, drinks alcohol occasionally, and walks two miles daily. Her family history is notable for hypertension in her father. She reports her last colonoscopy was at age 62 and was normal, and her last mammogram was six months ago and normal. Which of the following screening tests is most appropriate to order for this patient today?

  1. Dual-energy x-ray absorptiometryCevap
  2. B
    Low-dose computed tomography of the chest
  3. C
    Abdominal aortic ultrasound
  4. D
    Transvaginal ultrasound of the pelvis
  5. E
    Resting 12-lead electrocardiogram

Cevap

Dual-energy x-ray absorptiometry
The United States Preventive Services Task Force (USPSTF) recommends screening for osteoporosis with bone measurement testing (such as dual-energy x-ray absorptiometry) in women aged 65 years and older to prevent osteoporotic fractures. This patient has just reached the age milestone of 65 and requires this one-time baseline screening, regardless of her excellent health status and lack of specific clinical risk factors.

Adım Adım Çözüm

1
Identify the patient's demographic profile and active risk factors.
The patient is a 65-year-old female with no history of tobacco use and up-to-date breast and colon cancer screenings.
Preventive screening guidelines are heavily dependent on age, biological sex, and specific risk exposures (e.g., smoking).
2
Apply age-based United States Preventive Services Task Force (USPSTF) screening guidelines.
The USPSTF recommends routine screening for osteoporosis with bone measurement testing in all women aged 65 years and older.
Age 65 is the threshold where the risk of osteoporotic fractures in women justifies universal screening regardless of other clinical risk factors.
3
Select the appropriate diagnostic modality for the indicated screening.
Dual-energy x-ray absorptiometry (DEXA) is the gold standard and indicated test.
DEXA precisely measures bone mineral density at the hip and lumbar spine to diagnose osteoporosis.

Anahtar Kavram

The USPSTF recommends routine osteoporosis screening with bone measurement testing (e.g., dual-energy x-ray absorptiometry) for all women aged 65 years and older.
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Preventive Care and Screening

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