Fam Med Recommendations

Question 1

AAA screening:

Answer 1

Grade – B

One-time screening by US in men 65-75 who have ever smoked

Question 2

Aspirin as a preventive medication:

Answer 2

Grade – B
Who: adults 50-59yrs w/ a >10% 10-year cardiovascular risk
Low-dose aspirin as a primary prevention of CVD and colorectal ca. in these adults who aren’t at increased risk of bleeding, have a life expectancy of 10+ yrs and are willing to take the Rx for at least 10 years

Question 3

Bacteriuria screening:

Answer 3

Grade – A

Screen all pregnant women for asx bacteriuria w/urine culture at 12-16 weeks or 1st visit if later than this

Question 4

Blood Pressure Screening:

Answer 4

Grade – A
Screen for HTN in adults 18+
Recommendation to obtain measurements outside of clinical setting for confirmation before starting tx.

Question 5

BRCA risk assessment and genetic counseling/testing:

Answer 5

Grade – B
PCPs should screen women who have Fhx of breast, ovarian, tubal, or peritoneal ca.
Women w/positive screening results should receive genetic counseling and possibly BRCA testing

Question 6

Breast ca. preventive medications:

Answer 6

Grade – B
For women who are at increased risk for breast ca., and low risk for adverse Rx effects, clinicians should offer to prescribe risk-reducing meds like tamoxifen/raloxifene

Question 7

Breast ca. screening:

Answer 7

Grade – B

Screening mammography is recommended for women w/ or w/o clinical breast exams every 1-2yrs for women 40+

Question 8

Breastfeeding interventions:

Answer 8

Grade – B

Recommended to provide interventions during pregnancy and after birth to support breastfeeding

Question 9

Cervical ca. Screening:

Answer 9

Grade – A
Recommended screening every 3yrs w/cervical cytology alone in women 21-29
Women 30-65: screening every 3 yrs w/cervical cytology alone, every 5yrs w/HPV testing alone, or co-testing every 5yrs.

Question 10

Chlamydia screening:

Answer 10

Grade – B

Screen sexually active women age 24 or younger and in older women at increased risk.

Question 11

Colorectal ca. screening:

Answer 11

Grade – A

Screening starting at age 50 and continuing until age 75

Question 12

Dental caries prevention:

Answer 12

Grade – B
In all infants and children up to age 5 its recommended the application of fluoride varnish to primary teeth starting at the age of primary tooth eruption
Recommended that PCPs prescribe oral fluoride supplementation starting at age 6mo for children whose water supply is fluoride deficient.

Question 13

Depression screening:

Answer 13

Grade – B
Screening for MDD in adolescents aged 12-18
Screening in general adult population including pregnant and post-partum women

Question 14

Diabetes screening:

Answer 14

Grade – B
Screen for abnormal blood glucose as part of CVS risk assessment in adults 40-70yrs who are overweight or obese.
PCPs should offer or refer pts w/abnormal results to behavior counseling and interventions to promote healthful diet and physical activity

Question 15

Falls Prevention:

Answer 15

Grade – B

Recommended exercise interventions to prevent falls in community-dwelling adults 65+ at increased risk for falls

Question 16

Folic acid Supplementation:

Answer 16

Grade – A

Recommended all women of child-bearing age take daily supplement containing 0.4-0.8mg of folic acid

Question 17

gDM screening:

Answer 17

Grade – B

Screen for gDM in asx pregnant women 24+ weeks gestation

Question 18

Gonorrhea pphx Rx in newborns:

Answer 18

Grade – A

Recommended pphx ocular topical meds for all newborns to prevent gonococcal ophthalmia neonatorum

Question 19

Gonorrhea screening for women:

Answer 19

Grade – B

Recommended gonorrhea screening in sexually active women 24 or younger, and in older women at increased risk.

Question 20

Healthy diet and physical activity counseling to prevent CVD:

Answer 20

Grade – B
Recommends offering or referring adults who are overweight or obese and have additional CVD risk factors to intensive behavioral counseling interventions to promote a healthful diet and physical activity for CVD prevention.

Question 21

Hemoglobinopathy screening:

Answer 21

Grade – A

Recommended screening for sickle cell disease in all newborns

Question 22

Hep B screening in nonpregnant patients:

Answer 22

Grade – B

Recommended screening for HBV in persons at high risk for infection.

Question 23

HBV screening in pregnant women:

Answer 23

Grade – A

Recommended screening for HBV at first prenatal visit.

Question 24

HCV screening:

Answer 24

Grade – B
Screen persons at high risk for infection
Offer one-time screening for HCV infection in adults born between 1945-1965

Question 25

HIV screening in nonpregnant patients:

Answer 25

Grade – A
Clinicians should screen for HIV infection in adolescents and adults age 15-65.
Younger and older pts should be screened as well if at increased risk

Question 26

HIV screening in pregnant women:

Answer 26

Grade – A

All pregnant women should be screened, including those who present in labor who are untested with an unknown HIV status.

Question 27

Hypothyroidism screening in newborns:

Answer 27

Grade – A

Recommended screening for congenital HoThyroidism in all newborns

Question 28

Intimate partner violence screening:

Answer 28

Grade – B
Recommended clinicians screen for intimate partner violence in women of reproductive age and provide/refer women who screen positive to ongoing support services

Question 29

Lung ca. screening:

Answer 29

Grade – B
Recommended annual screening for lung ca. w/low-dose CT in adults ages 55-80 who have a 30 pack year smoking hx and currently smoke or have quit w/in the past 15 years.
Screening can be discontinued once a person hasn’t smoked for 15yrs or develops a health problem that substantially limits life expectancy

Question 30

Obesity screening and counseling:

Answer 30

Grade – B
Adults – Recommended that clinicians offer or refer adults w/BMI >30 behavioral interventions.
Children – screen for obesity in children and adolescents 6+ and offer/refer them to behavioral interventions to improve wt. status.

Question 31

Osteoporosis (age <65):

Answer 31

Grade – B
Screen for osteoporosis w/bone measurement testing to prevent osteoporotic fractures in postmenopausal women younger than 65yrs at increased risk of osteoporosis.

Question 32

Osteoporosis (age >65):

Answer 32

Grade – B

Screen for osteoporosis w/bone measurement testing to prevent fractures in women 65+

Question 33

Perinatal depression (counseling and interventions):

Answer 33

Grade – B
Recommended that clinicians provide or refer pregnant and postpartum women at increased risk of perinatal depression to counseling interventions

Question 34

Phenylketonuria:

Answer 34

Grade – B

Screen for PKU in all newborns

Question 35

Preeclampsia (prevention-aspirin):

Answer 35

Grade – B

Recommended to use low-dose aspirin (81mg) as preventive meds after 12 weeks of gestation in women who are at high risk

Question 36

Preeclampsia (screening):

Answer 36

Grade – B

Recommended screening in pregnant women w/BP measurements throughout pregnancy

Question 37

Rh incompatibility screening:

Answer 37

1st pregnancy visit (Grade A) – Rh (D) blood typing and Ab testing should be done for all pregnant women during 1st visit.
24-28 weeks (Grade B) – repeated testing should be done for all unsensitized Rh-D negative women 24-28weeks unless the father is known to be Rh neg.

Question 38

STI counseling:

Answer 38

Grade – B
Recommended intensive behavioral counseling for all sexually active adolescents and for adults who are at increased risk.

Question 39

Skin ca. behavioral counseling:

Answer 39

Grade – B
Recommended counseling in young adults, adolescents, children and parents of young children about minimizing exposure to UV radiation for pts. 6mo-24yrs w/fair skin types to reduce risk.

Question 40

Syphilis screening:

Answer 40

Grade – A

Recommended screening for syphilis infection in persons at increased risk and in all pregnant women

Question 41

Tobacco use counseling and interventions:

Answer 41

Grade – A
All pregnant and non-pregnant adults should be asked about tobacco use, and advised to stop using tobacco, and provided behavioral interventions and pharmacotherapy (but not for pregnant women)

Question 42

TB screening:

Answer 42

Grade – B

Recommended screening for latent TB in populations at increased risk

Question 43

Vision screening in children:

Answer 43

Grade – B

Recommended vision screening at least once in all children age 3-5 to detect amblyopia or its risk factors.