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Age
0%
0/5
Body mass index
Estrogen therapy
Race
Smoking history
80%
4/5
Select Answer to see Preferred Response
This patient has a significant smoking history which is a risk factor for osteoporosis. Osteoporosis is the most common metabolic bone disease. It is characterized by loss of bone matrix/mineralization, reduced bone mass/density, and reduced thickness of cortical and trabecular bone. Causes of osteoporosis include glucocorticoid use, physical inactivity, hyperthyroidism, and calcium deficiency. Individuals at risk for osteoporosis include Caucasians, women, those with a low body mass index, smokers, and those who are postmenopausal (from decreased estrogen levels). Patients at risk for osteoporosis should be screened using a DEXA scan for central bone density (hip and lumbar spine). The treatment of osteoporosis is elimination of risk factors (such as smoking), weight bearing exercise, and calcium/vitamin D supplementation. Medical treatment for severe or refractory osteoporosis can include bisphosphonates. Incorrect Answer: Answer 1: Age is not a risk factor for this patient as she is not considered elderly and is premenopausal. Given her premenopausal status, smoking is a more important risk factor for her. Answer 2: Body-mass index can be a risk factor if the patient has a low BMI (< 19 kg/m^2). A normal BMI or being overweight is not considered a risk factor. Answer 3: Estrogen therapy is protective against osteoporosis (though this is not an indication for starting oral contraceptive pills or estrogen replacement therapy). Answer 4: Race is a risk factor if the patient is Caucasian; however, African American race is not considered a risk factor. Bullet Summary: Smoking is an important modifiable risk factor for osteoporosis.
4.0
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