Screening Flashcards
Diabetes screening ; when do you start and how often?
Testing should be considered for those ≥45 years of age and repeated every 3 years, if results are normal.
Exception for diabetes screening for those younger than 45 years old
Testing should be considered younger or more frequently for those who:
(i) are African-, Hispanic-, Native-, Asian-, or Pacific Island-American
(ii) are overweight (BMI, kg/m2 ≥ 25);
(iii) have had gestational diabetes or delivered a baby weighing >9 pounds;
(iv) have a positive family history of diabetes (parents or siblings);
(v) have hypertension (blood pressure ≥ 140/90 mmHg);
(vi) have low HDL cholesterol (≤ 35 mg/dl) and/or high triglyceride level (≥ 250 mg/dl);
(vii) have had impaired glucose (110 ≤ fasting plasma glucose < 126 mg/dl or 140 ≤ oral glucose tolerance test < 200 mg/dl).
The USPSTF recommends screening for type 2 diabetes in adults with hypertension or hyperlipidemia.
In adults ≥20 years of age, a fasting lipoprotein profile (tot
al cholesterol, LDL and HDL cholesterol) is recommended every 5 years. More frequent measurements are recommended for persons with multiple risk factors or
What happen if the blood sugar testing is non fasting?
If the testing opportunity is non-fasting, only the values for total and HDL cholesterol will be usable.
In such a case, if total cholesterol ≥200 mg/dL or HDL < 40 mg/dL, a follow-up lipoprotein profile is needed for appropriate management based on LDL.
As per USPTFE, When should we screen lipid if patient have other comorbidity.
men aged ≥35 years and women aged ≥45 years and younger adults (men 20–35 and women 20–45 years) if they have other risk factors for coronary heart disease (diabetes, a family history of cardiovascular disease before age 50 years in male relatives or age 60 years in female relatives, a family history suggestive of familial hyper-lipidemia, multiple coronary heart disease risk factors [e.g. tobacco use, hypertension]
What is the target cholesterol level for people with diabetes?
Target LDL cholesterol levels for adults with diabetes are <100 mg/dl (2.60 mmol/l);
HDL cholesterol levels are >40 mg/dl (1.02 mmol/l);
and triglyceride levels are <150 mg/dl (1.7 mmol/l).
In women, who tend to have higher HDL cholesterol levels than men, an HDL goal 10 mg/dl higher may be appropriate
what is cotesting?
Hrhpv and cervical cytology every 5 years
•Cancer Screening
ØBreast
ØCervical (Endometrium)
ØProstate age
ØColon and rectum age
ØBreast (Age 50 -74 every 2 years)
ØCervical (Endometrium) USPST 21-65 q 3 yrs.
ØProstate age 50
ØColon and rectum age 50
Screening for TB Who should be screened?
•Recommended for patients who have been exposed to individuals with TB, inject street drugs, are from countries where TB is common, or spend time in areas of active TB
How you can screen latent TB?
Mantoux tuberculin skin test (TST)
Interferon-gamma release assays (IGRAs);
both are moderately sensitive and highly specific
Cervical Cancer Screening Recomendation:
Age less than 20 years. Hix of Std, may or may not have HPV vaccine, age of onset of sexual activity. SHOULD YOU PERFORM PAP TEST?
Absolutely NO PAP for age less than 20 years/
Pelvic exam and STI screening should be done.
Cervical cancer screening
Ages 21- 29 years; multiple sex partner or not, what exam should be done
pelvic exam . pap smear, STI screening should be done
Absolutely no - HPV test ( cotest or single test)
Cervical cancer screening; Ages 30 to 65 years, ( multiple sex partner or not)
Cotest preferred- cytology ( pap smear and HPV test
Pelvic exam and Appropriate STI test should be performed as per the risk
Cervical cancer screening- For ages 65 and above- Do they need pap smear?
NO
Cervical cancer screeening - regardless of age- removal for uterus ( hysterecto,my and cervix. Do you do pap smear?
NO
