Screening Protocols

Question 1

Colon cancer screening ages

Answer 1

Begin at 50
If one family member has colon cancer start at 40 or 10 years before onset of family member repeat in 3-5 years
If dx c ulcerative colitis, start screening c yearly colonoscopy 8ys p dx.

Fecal occult blood test every year with flexible sigmoidoscopy every 5 years
Fecal occult blood test every year with colonoscopy every 10 years

Polyps or personal history of CRC-repeat every 3 years if normal repeat in 5 years

FAP: consdier colectomy if positive genetic testing at 10 if not colonoscopy every 1-2 years beginning at puberty

HNPP: genetic testing at 21 Colonscopy every 2 years until 40 and then every year thereafter

Question 2

Diagnostic study of choice for positive fecal occult blood test

Answer 2

Colonoscopy

Question 3

Breast cancer

Answer 3

Women 50-75y
Mammogram every yearly

> 40 every 1-2 years

Question 4

Cervical cancer

Answer 4

Women 21-65y

Pap smear every 3 years

Question 5

HIV

Answer 5

15-65y
HIV antibody screen 1 time plus p24 Ag

Annual: ivdu, msm, sex for money, partner hiv+, homeless

Additional: pregnancy, occupational exposure, new STD symptoms, prior to any new sexual relationship

Question 6

Hyperlipidemia

Answer 6

Men 35+

Lipid panel every 5 years

Question 7

Hypertension

Answer 7

18+

Blood pressure every 2years

Question 8

Osteoporosis

Answer 8

Women 65+
DEXA, interval uncertain
Or significant risk factors

Question 9

Lung cancer

Answer 9

> 30 PYH & quit less than 15 years ago/ current smoker;

Low dose CT scan chest

Question 10

Diabetes screening recommendation

Answer 10

start at 45 y.o and every 3 years after

early screening if have: obesity, family history, history of gestational diabetes, native americans, african americans

Question 11

Hepatitis C associated hepatocellular carcinoma in pt c cirrosis

Answer 11

U/S every 6months

Question 12

Prostate cancer screening

Answer 12

Digital rectal exam
If abnormal perform transrectal ultrasonography
induration, assymmetry or palpable nodularity-biopsy indicated
If PSA less than 4.0 and DRE is negative annual follow up indicated
if PSA is 4-10 and DRE is negative biopsy indicated
PSA greater than 10 transrectal ultrasnography with biopsy is indicated regardless of DRE findings

Biopsy also indicated if PSA velocity >.75 per year

Question 13

Asplenic

Answer 13

H. flu type B, menigococcal (every 5 years) and pneumococcal vaccines
14 days between asplenic & vaccination

Question 14

Influenza vaccine

Answer 14

Adults >50 ors less than 50 with chronic medical problems

Health care workers, pregnant women in 2-3 trimester

Annually (Oct. Nov.)

Question 15

Pneumococcal polysaccharide vaccine (23 valent)

Answer 15

> 65
Sickle cell or asplenia
Chronic medical problems

one time dose
second dose 5 years later for asplenia, immunodeficient and on dialysis

Question 16

Tetanus/diptheria

Answer 16

Everyone receives

Primary: 1, 2 and 6-12 months
Booster every 10 years after that