Preventative Medicine

Question 1

What are the vaccine recommendations for patients over 65 years of age?

Answer 1

Influenza vaccine annually
Pneumococcal vaccines (both PCV13 and PPSV23)
Tetanus, diphtheria, and acellular pertussis (Tdap) vaccine

Question 2

What cancer is responsible for the most cancer-related deaths in the U.S. annually?

Answer 2

Lung Cancer

For both men and women

Question 3

When should colon cancer screening begin in average-risk patients?

Answer 3

Either cologard or colonoscopy begining at age 45 to

Question 4

What are the different stool tests avaialble for colon cancer screening?

Answer 4

• Guaiac-based fecal occult blood (gFOBT) – once per year
• Fecal immunochemical test (FIT) – once per year
• FIT-DNA test or COLOGARD (combines FIT with a test that detects altered DNA in stool) – once every one or three years

Question 5

What type of polyps, if found on colonoscopy, are more likely to be malignant?

Answer 5

Sessile polyps > 1cm

Question 6

A 30-year-old woman inquires when she should have her first mammogram. Her family history is significant for the death of her mother and grandmother due to breast cancer at the age of 32 years. Presently, the woman is asymptomatic. What is the recommendation for mammography for this patient?

Answer 6

Immediately

ACOG recommends annual breast exams and mamography for individuals with strong family history to begin at age 30

Question 7

Is alcohol consumption associated with an increased risk for breast cancer?

Answer 7

Yes

Question 8

A 51-year-old man presents to his family clinician for his annual wellness check. His colonoscopy 1.5 years ago detected two noncancerous polyps, which were removed. His history includes smoking one pack of cigarettes per day from age 18–50. Medications include lisinopril and allopurinol. Vital signs are BP of 120/80 mm Hg, HR of 70 bpm, RR of 16/min, T of 97.8°F, and BMI of 28 kg/m2. His lipid profile shows an LDL of 110 mg/dL, HDL of 55 mg/dL, and total cholesterol of 215 mg/dL, for a calculated total 10-year atherosclerotic cardiovascular disease risk of 4%. CMP values are within normal limits. Uric acid is 7 mg/dL. His heart has a regular rate and rhythm, lungs are clear to auscultation, bowel sounds are active, and prostate is smooth and walnut sized. What is the best next step in management?

Answer 8

Order a low dose Chest CT

Question 9

What is the USPSTF’s recommendation for screening for AAA?

Answer 9

The USPSTF recommends a screening with an abdominal ultrasound in men after the age of 65 years if they have ever smoked

Question 10

What is the most common type of non-small cell lung cancer, and in what part of the lungs is it typically found?

Answer 10

Adenocarcinoma, which is typically found in the outer portions of the lungs

Question 11

Which of the following patients is most appropriate for osteoporosis screening using dual-energy X-ray absorptiometry scanning?

A. A 45-year-old woman with a body mass index of 25 kg/m2 and maternal history of a hip fracture

B. A 54-year-old woman with a body mass index of 23 kg/m2 and recent distal radius fracture from a fall at home

C. A 59-year-old woman with a body mass index of 26 kg/m2, remote smoking history (quit 30 years ago), and recent 10-day course of glucocorticoids for asthma exacerbation

D. A 62-year-old woman with a body mass index of 27 kg/m2 and recent fifth metatarsal fracture while playing soccer

Answer 11

A 54-year-old woman with a body mass index of 23 kg/m2 and recent distal radius fracture from a fall at home