Preventive Medicine

Question 1

Cervical Cancer Screening

Answer 1

Women 21-65. If 21-29, q3y with cervical cytology alone. If 30-65, q3y with cervical cytology or q5y with hrHPV screening or q5y with cotesting.

Question 2

Colorectal Cancer Screening

Answer 2

Adults 50-75. Annual w/ FIT or q10y with flex sig + annual FIT or q10y with colonoscopy or q5y with CT colonography

Question 3

Folic Acid for Prevention of Neural Tube Defects

Answer 3

All women who are planning or capable of pregnancy. 0.4-0.8mg daily.

Question 4

HIV Screening

Answer 4

15-65. Increase frequency if high risk.

Question 5

HIV PrEP criteria for MSM

Answer 5

1. Serodiscordant sex partner
2. Inconsistent use of condoms
3. STI with syphilis/gonorrhea/chlamydia within last 6 months

Question 6

HIV PrEP criteria for heterosexuals

Answer 6

1. Serodiscordant sex partner
2. Inconsistent use of condoms with partner whose HIV status is unknown or high risk (MSM, IV drug use)
3. STI with syphilis/gonorrhea/chlamydia within last 6 months

Question 7

HIV PrEP criteria for IV drug use

Answer 7

1. Shared use of drug injection equipment
2. Serodiscordant sex partner
3. Inconsistent use of condoms with partner whose HIV status is unknown or high risk (MSM, IV drug use)
4. STI with syphilis/gonorrhea/chlamydia within last 6 months

Question 8

Syphilis screening

Answer 8

1. Pregnant women

2. Asymptomatic adults and adolescents who are at higher risk

Question 9

Abdominal Aortic Aneurysm screening

Answer 9

Men 65-75 who have ever smoked. Using abdominal ultrasonography.

Question 10

Aspirin use for preventing CVD (cardiovascular disease) and CRC (colorectal cancer)

Answer 10

Adults 50-59 with a >10% 10-year CVD risk

Question 11

BRCA 1/2 screening

Answer 11

Women with a personal or family history of breast, ovarian, tubal or peritoneal cancer using a familial risk assessment tool

Question 12

Breast cancer preventive medications

Answer 12

Use risk assessment tool and prescribe if risk >3% over next 5 years and low risk of adverse effects.

1. Tamoxifene (agonist on bone and uterus, antagonist on breast)
2. Raloxifene (agonist on bone, antagonist on uterus and breast)

Question 13

Breast cancer screening

Answer 13

Women 50-74. Mammography q1-2y.

Question 14

Chlamydia/Gonorrhea screening

Answer 14

Sexually active women 24 and younger, older women who are at increased risk

Question 15

Diabetes screening

Answer 15

Adults 40-70 who are overweight or obese

Question 16

Hepatitis C screening

Answer 16

Adults 18-79

Question 17

Lung cancer screening

Answer 17

Adults 55-80 with 30 pack-year smoking history and currently smoke or quit in last 15 years. Low-dose CT annually (can stop if have not smoked in >15 years)

Question 18

Osteoporosis screening

Answer 18

1. Women 65 and older
2. Women <65 with risk factors (low BMI, EtOH consumption, current smoking, long-term steroid use, previous fractures and falls within last year)

Question 19

Statin for primary prevention of CVD

Answer 19

All of following criteria are met:

1. Age 40-75
2. One or more CVD risk factors (dyslipidemia, diabetes, hypertension or smoking)
3. > 10% 10-year risk of CV event