4.5 of 10 Ratings
A 64-year-old female presents to her primary care physician for an annual checkup. She states that her health is adequate, but she has not been doing well since her husband died last year. She is able to get by but admits to having trouble caring for herself, cooking, cleaning, and paying her bills. The patient complains of diffuse muscle aches and pains. She has a past medical history of anxiety and seasonal affective disorder. She is not currently taking any medications. On physical exam, you note a gaunt woman with a depressed affect. You note that her body mass index (BMI) and height have both decreased since her last annual visit. On physical exam, her cardiac, pulmonary, and abdominal exams are within normal limits. Lab work is drawn and is as follows:Serum:Na+: 135 mEq/LK+: 3.7 mEq/LCl-: 100 mEq/LHCO3-: 23 mEq/LUrea nitrogen: 7 mg/dLGlucose: 70 mg/dLCreatinine: 0.8 mg/dLCa2+: 8.0 mg/dLMg2+: 1.5 mEq/LParathyroid hormone: 855 pg/mLAlkaline phosphatase: 135 U/LPhosphorus: 2.6 mg/dL Hemoglobin: 14 g/dLHematocrit: 36%Platelet count: 187,000/mm^3Leukocyte count: 4,700/mm^3What is the most likely diagnosis?
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A 67-year-old Caucasian female presents to her primary care physician after a screening DEXA scan reveals a T-score of -3.0. She smokes 1-2 cigarettes per day. She lifts weights several times a week. Which of the following measures would have reduced this patient's risk of developing osteoporosis?
Reduced physical activity to decrease the chance of a fall
Initiating a swimming exercise program three days per week
Intranasal calcitonin therapy
Calcium and vitamin D supplementation
A 47-year-old African-American woman presents to her primary care physician for a general checkup appointment. She works as a middle school teacher and has a 25 pack-year smoking history. She has a body mass index (BMI) of 22 kg/m^2 and is a vegetarian. Her last menstrual period was 1 week ago. Her current medications include oral contraceptive pills. Which of the following is a risk factor for osteoporosis in this patient?
Body mass index