During a medication management visit, a 58-year-old woman asks about her current health maintenance requirements. She takes methotrexate and daily prednisone () for rheumatoid arthritis, which was diagnosed five years ago. She has never smoked cigarettes. Her body mass index is . A review of her preventive care history shows a normal screening colonoscopy three years ago, a negative primary human papillomavirus test two years ago, and a normal bilateral mammogram six months ago. She completed the recombinant zoster and 20-valent pneumococcal conjugate vaccine series last year. Which of the following is the most appropriate indicated preventive service for this patient at this time?
- Dual-energy x-ray absorptiometryCevap
- BFecal immunochemical testing
- CLow-dose computed tomography of the chest
- DRoutine cervical cytology
- EUltrasound of the abdominal aorta
Cevap
Dual-energy x-ray absorptiometry
The correct answer is dual-energy x-ray absorptiometry (DEXA) because the United States Preventive Services Task Force (USPSTF) recommends screening for osteoporosis in postmenopausal women younger than 65 years who have an increased risk for osteoporotic fractures. This patient has multiple strong risk factors, including chronic glucocorticoid therapy, rheumatoid arthritis, and a lower BMI. These factors result in a 10-year fracture risk equivalent to or greater than that of a 65-year-old average-risk woman, warranting immediate baseline screening.
Adım Adım Çözüm
Anahtar Kavram
Osteoporosis screening in high-risk postmenopausal women under age 65