View source for WBR1143

 {{WBRQuestion
|QuestionAuthor= {{PB}}
|ExamType=USMLE Step 2 CK
|MainCategory=Internal medicine
|SubCategory=Endocrine, Endocrine
|MainCategory=Internal medicine
|SubCategory=Endocrine, Endocrine
|MainCategory=Internal medicine
|SubCategory=Endocrine, Endocrine
|MainCategory=Internal medicine
|MainCategory=Internal medicine
|SubCategory=Endocrine, Endocrine
|MainCategory=Internal medicine
|SubCategory=Endocrine, Endocrine
|MainCategory=Internal medicine
|SubCategory=Endocrine, Endocrine
|MainCategory=Internal medicine
|SubCategory=Endocrine, Endocrine
|MainCategory=Internal medicine
|MainCategory=Internal medicine
|SubCategory=Endocrine, Endocrine
|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?
|Explanation=Osteoporosis is followed up with bone density scan or DXA.
|AnswerA=X ray survey of entire body
|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.
|AnswerB=Bone density scan
|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.
|AnswerC=MRI
|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.
|AnswerD=CAT scan
|AnswerDExp=CAT scan is not indicated, it can cause excess radiation exposure.  Osteoporosis is followed up with a bone density scan or DXA.
|AnswerE=PET scan
|AnswerEExp=The PET scan is indicated to identify metastasis in the body.   Osteoporosis is followed up with a bone density scan or DXA.
|References=http://www.ncbi.nlm.nih.gov/pubmed/18334497
|RightAnswer=B
|WBRKeyword=Hyperthyroidism, osteoporosis
|Approved=No
}}