Immunizations and Screenings

Question 1

Tdap

Answer 1

one dose of Tdap then booster every 10 years after
people around infants might want Tdap to protect both
a person with a puncture wound or laceration get booster unless they have had one in the last 5 years
once per pregnancy at 32-36 weeks

Question 2

HPV vaccine

Answer 2

3 doses up to age 26 for women and 21 for men and 26 for men who have sex with men
recommended for all boys and girls starting at age 11

Question 3

varicella vaccine

Answer 3

2 doses for anybody who doesn’t have documentation of 2 vaccines in lifetime or who hasn’t had chickenpox
even if a person has had shingles they should still get varicella vaccine if they have not received it

Question 4

pneumococcal vaccine

Answer 4

all adults 65 or older
all adults who smoke
residents of nursing homes
all adults who are diabetic, chronic lung disease, chronic CV disease, chronic renal disease, nephrotic syndrome, chronic liver disease, alcoholism, functional or anatomic asplenia
5 years after 1st done re dose people with chronic renal failure, nephrotic syndrome, functional or anatomic asplenia
anyone who gets a dose before 65 should get it again at 65

Question 5

varicella zoster vaccine

Answer 5

at age 60 whether or not they have had a previous case of shingles
goal it to prevent rash and postherpetic neuropathy
persons aged 60 or old w/ chronic medical conditions may be vaccinated unless their condition constitutes a contraindication, such as pregnancy or severe immunodeficiency

Question 6

influenza vaccine

Answer 6

all people 6 months or older should have an annual vaccine
contraindications - egg allergies
age 65 or older may opt for the high dose vaccine

Question 7

Pap smear

Answer 7

not needed before age 21 then every 3 years to age 65
women 30+ may opt to do pap plus HPV screening every 5 years
not needed before starting contraceptives in girls or women less than 21
not recommended for women after 65 unless at high risk for cervical cancer
not recommended for women after 65 unless at high risk for cervical cancer
not recommended for hysterectomy with cervix removal unless high grade precancerous lesion or cervical cancer
not recommended for HPV alone or in combination with cytology before age 30

Question 8

mammogram

Answer 8

AAFP recommends mammograms begin at 50 then every 2 years until 75
ACA recommends mammograms being at 40 then yearly

Question 9

colonoscopy

Answer 9

beginning at age 50 years to 75

not recommended to screen age 76 to 85 though some individual pt. specifics may make screening advisable

Question 10

prostate specific antigen

Answer 10

USPSTF/AAFP recommend against routine screening of PSA for prostate cancer
ACS recommends discussion with each man and evaluation of risk factors
men who have a primary relative with prostate cancer may consider testing at age 45 other men age 50 w/ or w/o DRE

Question 11

screening for abdominal aortic aneurysm

Answer 11

men one time screening by ultrasonography in men ages 65 to 75 years who have ever smokes
men 65 to 75 years who have never smoked rather than routinely screening all men in this group
women - no conclusive evidence to assess the balance of the benefits and harms of screening in those who have never smoked

Question 12

screening for gonorrhea and chlamydia

Answer 12

women age 24 and younger and in older women at increased risk of disease
not enough evidence to determine screening in men

Question 13

screening for HIV

Answer 13

adults ages 18 to 65
older adults who are at increased risk
all pregnant women