Guidelines for the Well-Woman Exam - CME Conferences
Guidelines for the Well-Woman Exam - CME Conferences
Guidelines for the Well-Woman Exam - CME Conferences
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2 nd Annual Primary Care Fall Conference Wednesday, October 24, 2012When to Consider BMDMeasurement in Young WomenEvidence Based Points – Use Z -score• The indications <strong>for</strong> measuring premenopausalBMD are: Malabsorption syndromes (level III) O.I. or o<strong>the</strong>r heritable bone disorders (III) >3 mos chronic steroids >2.5 mg/d pred (II-2) > 10 years chronic hypoestrogenism (II-2) Hx vertebral compression fracture Thalassemia major Chronic immobilization (e.g. Cerebral palsy)• Rubin L. JBMR. 1999; 14: 633-43BMD in Adolescents• Stress fractures in adolescents ormarathoners are NOT fragility fractures DXA is not indicated Consider anorexia / eating disorders• When DXA is indicated in anadolescent T-scores are inappropriate andmeaningless Z-score < -2.0 = “Low BMD <strong>for</strong>chronological age”David Plourd, MDWomen <strong>Exam</strong>
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