USPSTF

Question 1

AAA

Answer 1

One time screening men 65 to 75 who have ever smoked

Question 2

Aspirin

Answer 2

Primary prevention of CVD and CRC age 50 to 59 with 10% or greater ASCVD score, no bleeding risk, will live for 10 years, will take med for 10 years

Question 3

BRCA related risk

Answer 3

For patients with personal or family hx of breast Gyn CA or susceptibility to BRCA1/2 should be have risk assessment tool.
If positive, Genetic counseling and then genetic testing

Question 4

Breast CA meds to reduce risk

Answer 4

Age 35 years and older tamoxifen (premenopausal) and raloxifene (post menopausal) or aromatase inhibitor to lower risk od CA

Question 5

Breast CA screening

Answer 5

Biennial age 50 to 74

Question 6

Cervical CA

Answer 6

21 to 29: cytology Q3 years

30 to 65: cytology Q3 years or cytology and HPV Q5 years

Question 7

GC/chlam

Answer 7

Screen ALL sexually active females less than 24

Screen high risk females greater than 25

Question 8

Colorectal

Answer 8

Screen 45 to 49 years (B)

Screen 50 to 75 years (A)

Question 9

Dental caries

Answer 9

Screen from birth to 5 years

Oral flouride supplementation starting at 6 months if flouride deficient water

Question 10

Depression

Answer 10

Screen all adults, pregnant and postpartum for depression, frequency not specified

Screen for MDD in ages 12 to 18, frequency not specified

Question 11

Falls

Answer 11

Exercise intervention for community dwelling 65 and older or those with increased risk of falls

Group or individual PT

Balance training 3 days or more per week

150 mins per week of moderate intensity or 75 mins of vigorous intensity and muscle training activity 2 times per week

Question 12

Gestational DM

Answer 12

Screen 24 weeks or after

Question 13

CVD risk prevention

Answer 13

Behavioral counseling for healthy diet and physical activity

Question 14

Pregnancy weight

Answer 14

Offer behavioral counseling

Underweight: upto 28 to 40 lbs
Normal: 25 to 35 lbs
Overweight: 15 to 25 lbs
Obese: 11 to 20 lbs

Question 15

Hep B screening

Answer 15

• first prenatal visit
• Adults and adolescents with high risk:

Born in countries where HbSAg prevelance is 2% or greater

Injection drug users

MSM

HIV and sex partners

Needle sharing contacts

Household contacts of those with HBSAg positive

Question 16

Hep C

Answer 16

18 to 79 years

Question 17

HIV

Answer 17

All Pregnant or in labor

15 to 65 or anyone at risk

Question 18

BP

Answer 18

Screen 18 + at office

Annual screening for 40+ with high risk (black, overweight)

Q3 to 5 years 18 to 39 with no risk factors

Obtain outside BP measurement before starting treatment

Question 19

Intimate violence

Answer 19

Screen women of reproductive age

Screening tests:

HARK: Humiliation, afraid, rape, kick
HITS: hurt, insult, threaten, scream
E-HITS: Extended HITS
PVS: Partner violence screen
WAST: women abuse screening tool

Question 20

Screening for Latent TB

Answer 20

For high risk individuals

With TST or IGRA

Question 21

Preeclampsia

Answer 21

Baby aspirin for women with high risk of preeclampsia from 12 weeks of gestation

Screen for preeclampsia at each prenatal visit with BP

Risk factors for preeclampsia: 
Previous hx
Previous adverse pregnancy
Maternal DM htn renal or autoimmune dz
Multifetal gestation
Nulliparity
Obesity 
Blacks
Poor
Advance maternal age

Dx:
Bp > 140/90 on 2 occasions 4 hrs apart after 20 weeks
And
Proteinuria > 300 on 24 hr urine
Or
Thrombocytopenia, renal insuff, abnormal LFTs, pulm edema, cerebral/visual sx

Question 22

Lung CA screening

Answer 22

Low dose CT
50 to 80
20 pack year hx
Quit within 15 years

Question 23

Obesity pediatrics

Answer 23

6 + years

Behavioral counseling

Question 24

Ocular GC prevention

Answer 24

Erythromycin to prevent gonococcal ophthalmia neonatorum in newborns

Question 25

Osteoporosis

Answer 25

Screen 65+ women with BMD Screen postmenopausal women less than 65 based on clinical risk assessment tool (eg FRAX) ``` Risk factors: Parental hx of hip fx Smoking Excessive alcohol use Low body weight ``` * 1 in 3 men with hip fx will die within a year* * use FrAX: based on comparison of average acore of a 65 year old white woman with no risk factors. If higher, then screen*

Question 26

DM screening

Answer 26

35 to 70 years who are overweight or obese every 3 years

Question 27

PrEP

Answer 27

For high risk: MSM or heterosexual with one of: Serodiscordant sex partner or partner with injection drug use hx Inconsistent condom use STI within past 6 months Drug injectors with one of: Above parameters Shared needles *tenofovir and emtricitabine once daily*

Question 28

Rh D incompatibility

Answer 28

Screen for all at first prenatal care Rescreen Rh D negative women at 24 to 28 weeks u less dad is also Rh D negative

Question 29

STI behavioral counseling

Answer 29

For all high risk adolescents and adults

Question 30

Skin cancer prevention

Answer 30

Counsel 6 months to 24 years fair skinned to minimize UV Exposure C rating for counseling for over 24 years

Question 31

Statin Use

Answer 31

Hx of CVD use low/moderate statin if all are pos: 40 to 75 years 1 or more cvd risk factor (chol, htn, dm, smoking) Calculated ascvd score > or equal to 10%

Question 32

Syphillis screening

Answer 32

Screening in those with increased risk and all pregnant women

Question 33

Tobacco cessation counseling and intervention

Answer 33

In all patients school age children to adults pregnant and non pregnant

Question 34

Alcohol and drug use screening

Answer 34

All adults 18 +

Question 35

Vision screening pediatrics

Answer 35

3 to 5 to detect amblyopia

Question 36

Obesity

Answer 36

Adults with BMI > 30 need multicomponent behavioral intervention

Question 37

I recommendations Insufficient evidence

Answer 37

Insufficient evidence to screen for chlamydia and gonorrhea in men Insufficient evidence to screen for gestational diabetes and pregnant patients before 24 weeks Insufficient evidence the screen for vitamin D deficiency Insufficient evidence to screen for hearing loss in older adults Insufficient evidence for pharmacotherapy for tobacco cessation and pregnant patients Insufficient evidence to assess benefits in harms of electronic cigarettes Insufficient evidence for screening of hypertension in children Insufficient evidence to screen for drug use and children Insufficient evidence to screen for cognitive impairment in older adults Insufficient evidence to screen for AAA in women with risk factors Insufficient evidence to screen for blood blood levels and children and pregnant patients Insufficient evidence to screen for atrial fibrillation with echocardiograph Insufficient evidence to screen for PAD with ABI Insufficient evidence to screen for CVD in asymptomatic patients with a ABI or CRP or calcium score Insufficient evidence to screen for osteoporosis in men

Question 38

D recommendations More harm than good

Answer 38

Do not screen for coronary artery stenosis Do not screen for BV in pregnant patients with no risk for preterm delivery Do not screen for AAA and women with no risk factors Do not screen for bacteriuria in asymptomatic non-pregnant patient Do not screen for pancreatic, ovarian, thyroid or testicular cancer Do not screen with EKG for CVD in asymptomatic patients Do not screen four prostate cancer with PS a for and 70 and older Do not screen for genital herpes in any patient Do not use estrogen alone or combined estrogen and progesterone for chronic conditions in postmenopausal women

Question 39

C recommendations Shared decision making

Answer 39

Screening for colorectal cancer from age 76 to 85 Screening for AAA and men yes 65 to 75 who have never smoked Screening with PSA for prostate cancer in men 55 to 69 Screening for breast cancer between ages 40 and 49 Counseling two adults 24 years and older with fair skin to minimize exposure to UV radiation Statin used in patients with a ASCVD score 7.5 to 10% Aspirin use in patients 60 to 69 years