American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the recommended frequency for dual-energy x-ray absorptiometry scans in postmenopausal patients taking aromatase inhibitors?

1. Every year

2. Every 2 years

3. Every 3 years

4. Every 5 years

The correct answer is: Every 2 years

Dual-energy x-ray absorptiometry (DEXA) scans are essential for monitoring bone density, particularly in postmenopausal women who are at higher risk for osteoporosis, especially those undergoing treatment with aromatase inhibitors. Aromatase inhibitors reduce estrogen levels, which can lead to bone loss and increase the risk of fractures. The recommended frequency of DEXA scans for this population is every 2 years. This interval is supported by guidelines that emphasize the need to monitor bone density regularly in patients on aromatase inhibitors, as significant bone loss can occur within the first few years of treatment. Scanning every 2 years allows for timely intervention if there is a significant decrease in bone density, which can guide treatment options to mitigate fracture risk. In contrast, more frequent scans—such as annually—might lead to unnecessary exposure to radiation and increased healthcare costs without providing additional benefit, as critical changes in bone density may not occur within a quicker timeframe. Scanning every 3 or 5 years may underestimate the risk of osteoporosis development in this high-risk group, delaying necessary preventative measures or treatments. Therefore, the 2-year interval strikes a balance between effective monitoring and patient safety.