Please provide assessment and diagnosis. Also include what should be prescribed

Question

Please provide assessment and diagnosis. Also include what should be prescribed to this patient and the length of therapy.

A 72 yo woman of Asian descent has just transferred to your practice. She had a hysterectomy 8 years ago and has not been on hormone replacement therapy. She is 5-foot-2 and weighs 102 lbs. She has had a sedentary lifestyle and drinks 4 glasses of wine per day. Her mother died at age 62 from complications of a hip fracture and her sister (age 58) was just diagnosed with metastatic breast cancer. You prescribe a DEXA scan and the results report a T score of -2.6 SD at the hip; -2.4 SD lumbar spine.

Explanation / Answer

The DEXA scan results are showing low bone density that means the patient is suffering from osteoporosis, which is a medical term for weak and fragile bones, which are prone to fractures, means bones can break very easily from falls. This is caused by lack of estrogen, since the patient had had hysterectomy and is not on hormone replacement therapy. The patient should also be screened for breast cancer, because she has a family history of breast cancer. After the screening, her treatment should be decided. She can be started on drugs for osteoporosis which prevent breast cancer as well, such as selective estrogen receptor modulators.

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