American Board of Internal Medicine (ABIM) Certification Practice Exam

Who should undergo osteoporosis screening?

1. Men aged 65 and older

2. Women aged 60 and older

3. Women aged 65 and older or younger women with a 10-year fracture risk of ≥ 9.3%

4. Individuals with a history of osteoporosis

The correct answer is: Women aged 65 and older or younger women with a 10-year fracture risk of ≥ 9.3%

Osteoporosis screening is recommended to identify individuals at increased risk of fractures due to low bone density. The guidelines specifically suggest that women aged 65 and older should undergo screening because of the increased prevalence of osteoporosis and fracture risk in this age group. Additionally, younger women who have specific risk factors, such as a 10-year fracture risk of 9.3% or higher, should also be screened. This approach addresses the need to identify and manage osteoporosis earlier in individuals who may not meet the age criteria but still have significant risk factors. The rationale behind screening younger women with a considerable fracture risk is based on the goal of preventive care. It allows for early intervention which could include calcium and vitamin D supplementation, lifestyle modifications, or medications to strengthen bone density. This evidence-based recommendation follows the principle of ensuring that those most likely to benefit from early detection and treatment of osteoporosis are appropriately screened. Men aged 65 and older and individuals with a history of osteoporosis might also warrant consideration of screening, but these factors alone do not fully encapsulate the current guidelines, which specifically emphasize the importance of screening based on age and calculated fracture risk. Thus, option C reflects the current best practice for osteoporosis screening by balance in both gender and specific clinical criteria.