Here are some scenario-based multiple choice questions related to dexa scans and bone scans:
Mary is a 65-year-old woman who recently underwent a bone scan. The results showed a T-score of -2.5 at the hip and spine. What does this indicate?
a) Normal bone density
b) Mild bone loss (osteopenia)
c) Severe bone loss (osteoporosis)
d) Bone cancer
Answer: c) Severe bone loss (osteoporosis)
A 65-year-old male patient presents with back pain and a history of prostate cancer. Which of the following bone scan results is most indicative of metastatic disease?
a. Focal area of increased uptake in the lumbar spine
b. Diffuse uptake throughout the vertebral bodies
c. No areas of abnormal uptake
d. Intense uptake in the ribs
Answer: A - Focal area of increased uptake in the lumbar spine is most indicative of metastatic disease. Metastases typically appear as areas of increased uptake on bone scans, and the location and pattern of uptake can provide clues as to the underlying disease.
A 30-year-old female patient presents with bone pain and a history of breast cancer. Which of the following imaging modalities would be most appropriate to evaluate bone metastases?
a. X-ray
b. MRI
c. CT scan
d. Bone scan
Answer: D - A bone scan would be the most appropriate imaging modality to evaluate bone metastases in a patient with a history of breast cancer. Bone scans are highly sensitive for detecting bone metastases and can detect changes in bone metabolism before changes are visible on X-rays.
A 50-year-old male patient presents with joint pain and a suspected diagnosis of osteoarthritis. Which of the following would be the most appropriate imaging study to confirm this diagnosis?
a. X-ray
b. MRI
c. CT scan
d. Bone scan
Answer: A - An X-ray would be the most appropriate imaging study to confirm the diagnosis of osteoarthritis in a patient with joint pain. X-rays can show joint space narrowing, osteophyte formation, and subchondral bone changes that are characteristic of osteoarthritis.
A 20-year-old female athlete presents with a stress fracture in her tibia. Which of the following imaging studies would be most appropriate to evaluate the extent of the injury?
a. X-ray
b. MRI
c. CT scan
d. Bone scan
Answer: A - An X-ray would be the most appropriate imaging study to evaluate the extent of a stress fracture in a patient with suspected bone injury. X-rays can show changes in bone density and the presence of fracture lines.
A 40-year-old male patient presents with suspected Paget's disease. Which of the following imaging studies would be most appropriate to evaluate this condition?
a. X-ray
b. MRI
c. CT scan
d. Bone scan
Answer: A - An X-ray would be the most appropriate imaging study to evaluate Paget's disease. X-rays can show changes in bone shape, density, and structure that are characteristic of Paget's disease. Bone scans may also be useful in evaluating the extent and activity of the disease.
What is the purpose of a DEXA bone scan?
A. To diagnose osteoporosis
B. To monitor the progression of osteoporosis
C. To assess fracture risk
D. All of the above
Answer: D. All of the above
What does DEXA stand for?
A. Dual-energy X-ray absorptiometry
B. Digital X-ray absorptiometry
C. Double-exposure X-ray analysis
D. Diagnostic X-ray assessment
Answer: A. Dual-energy X-ray absorptiometry
What part of the body is typically scanned during a DEXA bone scan?
A. The entire body
B. The arms and legs
C. The spine and hips
D. The skull
Answer: C. The spine and hips
How is bone density measured during a DEXA bone scan?
A. By measuring the amount of calcium in the bones
B. By measuring the thickness of the bones
C. By measuring the amount of radiation absorbed by the bones
D. By measuring the strength of the bones
Answer: C. By measuring the amount of radiation absorbed by the bones
What are the units used to express bone density?
A. Millimeters
B. Grams
C. Pounds
D. T-scores
Answer: D. T-scores
What is a T-score?
A. A measure of bone density that compares an individual's bone density to that of a healthy 30-year-old of the same sex
B. A measure of bone density that compares an individual's bone density to that of a healthy 50-year-old of the same sex
C. A measure of bone density that compares an individual's bone density to that of a healthy 70-year-old of the same sex
D. A measure of bone density that compares an individual's bone density to that of a healthy 90-year-old of the same sex
Answer: A. A measure of bone density that compares an individual's bone density to that of a healthy 30-year-old of the same sex
What T-score range is considered normal?
A. Above -1
B. Between -1 and -2.5
C. Below -2.5
D. Below -3
Answer: A. Above -1
What T-score range is considered osteopenia?
A. Above -1
B. Between -1 and -2.5
C. Below -2.5
D. Below -3
Answer: B. Between -1 and -2.5
What T-score range is considered osteoporosis?
A. Above -1
B. Between -1 and -2.5
C. Below -2.5
D. Below -3
Answer: C. Below -2.5
What is the recommended frequency for a DEXA bone scan for individuals with normal bone density?
A. Every 2 years
B. Every 5 years
C. Every 10 years
D. Every 15 years
Answer: C. Every 10 years
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