Screening tests

Question 1

FOBT screening test

Answer 1

every 2 years post 50 years old until age 75 years if consistent negative findings. This may be different if there is a family history of bowel cancer (Lynch/FAP).

Question 2

Pap smear

Answer 2

every 2 years after becoming sexually active

Question 3

what comprises an absolute CV risk assessment?

Answer 3

Smoking
Age
Gender
Diabetes
LVH on ECG
Systolic BP
Total cholesterol
LDL

Question 4

screening for chlamydia?

Answer 4

recommended for women aged 18 up to 29 annually

Question 5

who should get an absolute CV risk assessment

Answer 5

should be performed every 2 years in all adults aged 45 years and over who are not clinically at high risk already

or if Aboriginal and Torres Strait islander peoples aged 35 years

Question 6

who should be screened for diabetes?

Answer 6

every 3 years from age 40 for non-indigenous australians through AUSDRISK

Aboriginal and Torres Strait islander peoples should be screened from age 18

Question 7

what do we classify as high risk for developing diabetes?

Answer 7

AUSDRISK score of 12 or more
people with previous CV event
women with hx of gestational diabetes
women with PCOS
patients on anti-psychotic meds

Question 8

what do we do to screen for diabetes amongst high risk individuals

Answer 8

fasting blood sugar every 3 years

Question 9

who do we screen for breast cancer using mammograms?

Answer 9

women aged 50-69 years attend the BreastScreen Australia every 2 years using mammograms

Question 10

how do we screen for colorectal cancer amongst patients who are at moderate risk of CRC (eg FMH of CRC)

Answer 10

colonoscopy every 5 years from age 50 years or at 10 years younger than the age of first diagnosis of CRC in the family (whichever comes first)

Question 11

screening for prostate cancer is not recommended unless

Answer 11

1. the man specifically asks for it

2. he is fully counselled on the pros and cons

Question 12

when should we start reviewing fracture risk factors in men and women?

Answer 12

in women 45 years and men aged 50 years.

those with increased risk should have their bone mineral density checked

Question 13

for men who have sex with men, what are the screening tests we do for STIs and how frequent should we do them?

Answer 13

at least annually, but more frequently 3-6 monthly if multiple sexual partners, unprotected anal intercourse or sexual intercourse whilst using recreational drugs

Anal swab
First void urine sample
pharyngeal swab
-All looking for gonorrhoea/chlamydia

Serology: Hep B, C(?), Syphilis, HIV, hep A

Question 14

if a patient has tested positive for gonorrhoea or chlamydia, when should they be retested for STIs?

Answer 14

3 months after

Question 15

who should be screened for CKD?

Answer 15

1. Aboriginal and Torres Strait Islander patients aged 30 and over.
2. Non indigenous patients aged 60 and over
3. patients with diabetes, hypertension, CVD/PVD, metabolic syndrome
4. Patients with family hx of CKD

Question 16

what consists of a CKD screen?

Answer 16

serum creatinine
eGFR
urine albumin:creatinine ratio
urinanalysis

Question 17

if a patient comes in requesting a ‘STI screen’, and are heterosexual and asymptomatic and not high risk, what comprises of a typical STI screen in GP setting?

Answer 17

Urine PCR or genital swab for chlamydia

serology for hepatitis B (if not vaccinated or immune), syphilis and HIV

Question 18

describe ottawa ankle rules?

Answer 18

1. Tenderness posterior borders lower 6 cm of either malleoli
2. Tenderness base 5th metatarsal
3. Tenderness navicular
4. Unable to fully bear weight for 4 steps

–>anteroposterior + lateral x-ray