Screening Guidelines

Question 1

How often to screen for HTN? And in which population?

Answer 1

All adults 18+; every 2 years in those

Question 2

Who should be screened for HLD? And how often?

Answer 2

Healthy adults over 20 should be screened every 5 years by measuring a non-fasting total cholesterol and HDL cholesterol. If total cholesterol >240 or between 200-240 with multiple risk factors, get a complete lipoprotein profile.

Question 3

Colorectal Cancer Screening Guidelines for average risk patient:

Answer 3

(patients >50 years of age with no GI symptoms)—either of the following:

a. Fecal occult blood test every year, 1 flexible sigmoidoscopy every 5 years
b. Fecal occult blood test every year, 1 colonoscopy every 10 years

Question 4

Colorectal Cancer Screening Guidelines for Moderate-risk patients

Answer 4

Patients with single or multiple polyps, personal history of CRC—initial colonoscopy; repeat at 3 years—if normal, then colonoscopy every 5 years.

Family history of CRC or adenomatous polyps in first-degree relatives— colonoscopy at age 40 or 10 years younger than the youngest case in family; if normal, repeat in 3 to 5 years.

Question 5

Colorectal Cancer Screening Guidelines for High-risk patients

Answer 5

a. Families with familial adenomatous polyposis—genetic testing at age 10; con-
sider colectomy if positive genetic testing or polyposis is confirmed; if not,
colonoscopy every 1 to 2 years beginning at puberty
b. Families with hereditary nonpolyposis colorectal cancer—genetic testing at
age 21; if positive, colonoscopy every 2 years until age 40, and then every year thereafter

Question 6

Prostate cancer screening Guidelines

Answer 6

1. This is controversial.
2. The USPSTF has concluded that the evidence is not sufficient to determinewhether the benefits of widespread screening (early detection) outweigh the harms (e.g., false-positives, unnecessary treatments, expenses).

Question 7

Breast Cancer Screening Guidelines (USPSTF)

Answer 7

Women 50-74, mammogram every 2 years. No mammograms above the age of 75. Before 50 it is a personal decision.

Question 8

Cervical Cancer Screening Guidelines

Answer 8

Women 21-65 every 3 years with pap smear. For women 30-65, screen with pap smear + HPV testing every 5 years

Question 9

STI Screening Guidelines (USPSTF)

Answer 9

Chlamydia, gonorrhea, HIV, and syphilis screening for women who engage in high-risk sexual behavior (e.g., having multiple current partners, having a new partner, using condoms inconsistently, having sex while under the influence of alcohol or drugs, having sex in exchange for money or drugs)

chlamydia and gonorrhea screening for all sexually active women younger than 25 years (including adolescents), even if they are not engaging in high-risk sexual behaviors.2-3 Younger women have a higher risk of gonorrhea and chlamydia infection than older women; this is because younger women may have more new sex partners and because of the relative immaturity of their immune systems and the presence of columnar epithelium on the adolescent exocervix.

Question 10

Patients with asplenia need which vaccines?

Answer 10

HIB (H. influenza type B), meningococcal, pneumococcal vaccines.

Question 11

Colonoscopy Screening Guidelines

Answer 11

Patients who have one first degree relative diagnosed with colorectal cancer or adenomatous polyps before age 60, or at least two second degree relatives with colorectal cancer, are in the highest risk group. They should start colon cancer screening at age 40, or 10 years before the earliest age at which an affected relative was diagnosed (whichever comes first) and be rescreened every 5 years.