Medicine>>>>>Women’s Health
Question 4#

A 21-year-old woman presents for her annual examination. She enjoys drinking to excess on the weekends with her friends and smokes cigarettes to “keep her weight down.” She avoids dairy products because they cause bloating and diarrhea. Her medications include birth control pills and OTC antihistamine. She runs 3 miles per day at least 5 days per week. She is 5 ft 2 in and 105 lb. In addition to counseling her on using a barrier method for avoidance of sexually transmitted diseases,

what other advice should you give?

a. Binge drinking has no adverse health repercussions
b. She shouldn’t start vitamin D or calcium until after menopause
c. She should change her current exercise routine to water aerobics
d. She has several significant factors contributing to a low peak bone mass
e. Smoking is an acceptable form of weight control

Correct Answer is D


Peak bone mass is achieved around age 30, and is largely determined by genetics, nutrition, endocrine health, and physical activity. Cigarettes are a known toxin to bone metabolism. This patient’s weight bearing exercise should be continued, not replaced by nonweight bearing activities such as swimming or water aerobics. This patient should be advised to ingest, preferably through calcium-rich foods, the USDA recommended 1000 mg of calcium and 600 international units of vitamin D per day. Binge drinking increases her risk of sexual assault, fatal automobile accident, and alcohol poisoning. Other, less risky methods of weight maintenance should be recommended.