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A 73-Year-Old Woman With Osteoporosis
Discussant Susan L. Greenspan, MD
JAMA. 1999;281:1531-1540.
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INTRODUCTION
DR DALEY: Mrs Z is a 73-year-old married grandmother who lives in a suburb of Boston, Mass, with her husband. She works 4 days per week in her daughter's retail business. Her gynecologist recently referred her for evaluation of "thin bones." Mrs Z has medical insurance through Medicare and supplemental insurance.
Mrs Z underwent menarche at age 11 years and had normal menstrual periods until menopause at age 50 years. She had 2 uncomplicated pregnancies and took oral contraceptives for many years. After menopause, she took hormone replacement therapy (HRT) for only 3 years, then stopped because of fear of developing breast cancer. She smoked for 1 year in her teens and quit; she does not drink alcohol. She has never taken glucocorticoids, anticonvulsants, or thyroid medication. Her mother fractured her hip twice. There is no family history of breast cancer. The patient's daily dietary . . . [Full Text of this Article]
MRS Z: HER UNDERSTANDING AND PERCEPTIONS
DR H, THE PATIENT'S GYNECOLOGIST: HER UNDERSTANDING AND PERCEPTIONS
AT THE CROSSROADS: QUESTIONS TO DR GREENSPAN
Risk Factors Bone Mass Measurements Secondary Causes of Bone Loss General Preventive Measures Prevention and Treatment of Osteoporosis Treatment for Mrs Z
CONCLUSION
QUESTIONS AND DISCUSSION
Author Affiliation: Dr Greenspan is Director, Osteoporosis Prevention and Treatment Center, Director, Bone Density Testing Center, Program Director, Harvard-Thorndike General Clinical Research Center, Beth Israel Deaconess Medical Center, and Associate Professor of Medicine, Harvard Medical School, Boston, Mass.
RELATED ARTICLE
April 28, 1999
JAMA. 1999;281(16):1557-1558.
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