Screening

Question 1

Screening for HLD

Answer 1

17-21: One time, non-fasting, non-HDL

<21 screen was normal, high RF: screen from 25 for M, 35 for W

<21 screen was normal; and normal RF: 35 for M, 45 for W

RF: 
DM
HTN
Smoking
FHx
(2+ = high risk)

Question 2

Adult screening for DM

Answer 2

All adults with:

• HTN
• HLD
• BMI 25+ AND age 35-70

Fasting plasma glucose is best, otherwise A1C

Question 3

Breast cancer screening

Answer 3

Avg risk:

• Discuss starting at 40
• Recommend screening q1-2 years for 50-74 YO, or life expectancy <10 Y

Question 4

Cervical cancer screening

Answer 4

21-65 YO
21-29: HPV testing q5 years (average risk)
30-65: Co-test q5 years OR pap alone q3

STOP at 65+ if:

• Two consecutive (-) co-tests w/in last 10 years (most recent 5 years)
• 3 consecutive (-) paps w/in last 10 years (most recent 3 years)
• Two consecutive (-) HPV within past 5 years (most recent 5 years)

**USPSTF recommends screening until 70-75

Question 5

Colorectal cancer screening

Answer 5

Colonoscopy from 45 until 75-85

• FHx: initiate 10 years before relative or at 40, whichever is younger, 1 5
• Familial adenomatous polyposis: Begin at 10-15

Question 6

Lung cancer screening

Answer 6

Increased risk: low dose helical CT after age 50

RF:
- smoking: 20 pack year history, current or quit within past 15 years

Question 7

Prostate cancer screening

Answer 7

Shared decision making after age 50 in average risk
High risk: start discussions at 40-45
** RF: FHx, Black race, BRCA1/2

Question 8

Zoster vax

Answer 8

50+ YO

Question 9

Pneumococcal vax

Answer 9

65+ YO

19-64 with risk of pneumococcal disease

Question 10

Chlamydia and gonorrhea

Answer 10

Sexually active women <25 YO
High RF sexually active women >25 YO
HIV infection
MSM
Correctional facilities

Question 11

Hep C screening

Answer 11

1 time screening for all adults 18-79

Re-screen if high RF

Question 12

HIV screening

Answer 12

18-75

Question 13

Syphilis screening

Answer 13

Anyone considered high risk

Question 14

Osteoporosis screening

Answer 14

Women 65+
Post-menopausal women <65 with RF
Men w/ clinical signs of low bone mass

RF:

• chronic steroids
• parental hx of hip fracture
• low body weight
• EtOH abuse
• RA
• 2ndry osteoporosis

Question 15

AAA screening

Answer 15

1 time US for men 65-75 who have ever smoked

OR have a 1st degree relative who required surgery for AAA/ruptured

Question 16

CHADS2VASC

Answer 16

Clot risk in afib patients

• CHF
• HTN
• Age (65 = 1 pt, 75+ = 2 pt)
• DM
• Stroke (2 points)
• Sex (F)
• Vascular history - MI, PAD, plaque