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Posttraumatic stress disorder — USMLE Step 3 MCQ

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HardPsychiatry (outpatient management)Posttraumatic stress disorderUSMLE Step 3

A healthy 61-year-old postmenopausal woman has low body weight and a parental hip fracture but no fragility fracture or steroid use. What is the recommended screening sequence?

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Correct answer: D — Apply a clinical risk tool first; obtain DXA if risk is increased

The best answer is “Apply a clinical risk tool first; obtain DXA if risk is increased”. For women younger than 65, USPSTF uses risk factors followed by formal risk assessment to determine DXA eligibility. Women 65 or older receive DXA; postmenopausal women younger than 65 are first assessed for risk factors and then with a clinical risk tool before DXA if risk is increased. The alternatives use a different threshold, timing, population, or intervention and therefore do not match the clinical facts presented.

Reference: USPSTF: Osteoporosis Screening Clinician Summary: https://www.uspreventiveservicestaskforce.org/uspstf/document/clinical-summary/osteoporosis-screening