WBR1143

Author	[[PageAuthor::Pratik Bahekar, MBBS [1]]]
Exam Type	ExamType::USMLE Step 2 CK
Main Category	MainCategory::Internal medicine
Sub Category	SubCategory::Endocrine, SubCategory::Endocrine
Prompt	Prompt::The patient is moving to Nepal for next 4 years, which of the following tests you will recommend to follow up with a new primary care doctor?
Answer A	AnswerA::X ray survey of entire body
Answer A Explanation	AnswerAExp::X ray survey of entire body is not indicated, not only it causes excess radiation exposure but also, it will not be helpful to monitor the change in the bone density.
Answer B	AnswerB::Bone density scan
Answer B Explanation	[[AnswerBExp::Dual-energy X-ray absorptiometry is considered the gold standard for the diagnosis of osteoporosis. Osteoporosis is diagnosed when the bone mineral density is less than or equal to 2.5 standard deviations below that of a young (30–40-year-old, healthy adult women reference population. This is translated as a T-score. Normal: T-score ≥ 1.0 Osteopenia: T-score < −1.0to −2.5 Osteoporosis: T-score ≤ −2.5 Severe osteoporosis: T-score ≤ −2.5 with fragility fracture A bone density scan is used to monitor osteoporosis irrespective of it's etiology.]]
Answer C	AnswerC::MRI
Answer C Explanation	AnswerCExp::MRI is not indicated, and will not be helpful in the change in the bone density. If osteoporosis results in fracture nerve entrapment, a MRI is done to dignose and manage bone compression.
Answer D	AnswerD::CAT scan
Answer D Explanation	AnswerDExp::CAT scan is not indicated, it can cause excess radiation exposure. Osteoporosis is followed up with a bone density scan or DXA.
Answer E	AnswerE::PET scan
Answer E Explanation	AnswerEExp::The PET scan is indicated to identify metastasis in the body. Osteoporosis is followed up with a bone density scan or DXA.
Right Answer	RightAnswer::B
Explanation	[[Explanation::Osteoporosis is followed up with bone density scan or DXA. Educational Objective: References: http://www.ncbi.nlm.nih.gov/pubmed/18334497]]
Approved	Approved::No
Keyword	WBRKeyword::Hyperthyroidism, WBRKeyword::osteoporosis
Linked Question	Linked::
Order in Linked Questions	LinkedOrder::