Prevention Screening Extra Material

Question 1

Grabe A Recommendations

Answer 1

high certainty that the net benefit is substantial so the USPSTF recommends the service

Question 2

Grade B Recommendations

Answer 2

high certainty that the net benefit is moderate or that there is moderate certainty that the net benefit is moderate to substantial so the USPSTF recommends the service

Question 3

Grade C Recommendations

Answer 3

selective offerings or services provided to individual patients based on professional judgment and patient preferences. There is at least moderate certainty that the net benefit is small

Question 4

Grade D Recommendations

Answer 4

there is moderate or high certainty that the service has no net benefit or the harms outweigh the benefits

Question 5

Cervical Cancer Screening

Answer 5

Every 3 years by cytology alone, or every 5 years with PAP/HPV co-testing.

Starting at age 21. Be careful for tricks on test where they mix a cytology along with a HPV test at different intervals.

Question 6

Pneumonia Vaccine

Answer 6

Adults 65+
Adults less than 65 with risk factor (esp. smoking or asthma)

Doses:
One PCV20 (all in one)
OR PCV15 then one year later -> PPSV23
OR PPSV23 then one year later -> PCV15 or PCV20

Question 7

Best Alcohol Misuse Screening Tool

Answer 7

CAGE

The Audit and others are not as sensitive.

Question 8

Hemoccult Testing Used to Evaluate:

Answer 8

GI Tumors and Colorectal CA

It is of limited use in IBD, Hemorrhoids, Diverticular Disease

Question 9

Shigrix Vaccine

Answer 9

Inactivated - safe for immunocompromised

All adults 50+ should get it (two doses)
All adults 19+ with weak immune system should get it (2 doses)

Still not recommended in pregnancy or if patient has a fever or major illness

Question 10

AAA Screening

Answer 10

All men 65-75 who ever smoked and men >60 with family history of AAA

Question 11

Osteoporosis Screening

Answer 11

All women 65+

Question 12

Elderly Adults HTN Screening

Answer 12

Every visit!

Question 13

CURB-65 Scoring

Answer 13

For pneumonia
Score of 2 = Close observation, consider admission
Score of 3+ = admit to hospital

Question 14

“Tinkling” bowel sounds

Answer 14

Suggestive of a bowel obstruction
Any metallic, tinkling sounds are common in SBO

Question 15

Most common cause of Pancreatitis

Answer 15

Gall Bladder Disease - specifically gall bladder stones

Question 16

suppurative conjunctivits treatment

Answer 16

antibiotic drops or ointment
-Floxicans, erythromycin, Bacitracins

Penicillin is not used

Question 17

Asymptomatic Bacteriuria Screening in Pregnancy

Answer 17

Screen all pregnant women for asymptomatic UTI and treat. This is one of the few times you treat a asymptomatic UTI

Question 18

Breast Cancer Screening

Answer 18

Biennial screening mammogram for women age 50-74; start at age 40 if history of cancer in family

Question 19

Chlamydia and Gonorrhea for Women

Answer 19

All sexually active women 24 or younger; all women at higher risk that are 25 and older.

Question 20

Colorectal Cancer

Answer 20

Adults 45 (Grade B) or 50 (Grade A) - 75 years old. At 40 (or ten years less than family member diagnosed) if family history

Options:
FIT every year
CT every 5 years
Sigmoidoscopy every 5 years
Colonoscopy every 10 years

Question 21

HTN Screening

Answer 21

Every year in adults 40+ (or any age if any risk factors present)
Every 3-5 years if younger than 40 with no risks
Every visit if elderly with risk factors

Question 22

Gestational Diabetes

Answer 22

Screen at 24 weeks or after
If at higher risk, may repeat later

Question 23

Hep C Screening

Answer 23

One time screening, especially if born before 1965

Question 24

Lung Cancer

Answer 24

Low dose CT
Adults 50-80 with 20 pack-year smoking who still smoke or less than 15 years since quitting

Question 25

Diabetes

Answer 25

Age 35-70 who are overweight or obese
Every 3 years if no risk factors, annual if risk factors present

Question 26

Statin Recommendation

Answer 26

Adults with 1 or more CVD risk and a 10% risk of CV event should be on statins

Question 27

Dietary Guidelines

Answer 27

Half the plate should be fruits / veggies