Screening Recommendations

Question 1

what is american cancer society recommendations for mammography? vs. USPSTF

Answer 1

ACS: annual age 45-54, every 2 years after age 55: continue as long as women is in good health and expected to live 10+ years
USPSTF: every 2 years 50-74, 75+ no specific recommendation to discontinue

Question 2

when should PSA testing be routine?

Answer 2

all males age 50+ annual rectal exam and PSA test.

prior to that is controversial. may start as early as 40 if family history

Question 3

when should cholesterol testing begin?

Answer 3

age 20 year old, every 5 years unless > 200

Question 4

when to begin glaucoma screening

Answer 4

annually, age 45+

Question 5

when does herpes zoster vaccination begin?

Answer 5

age 50 years- series of 2 doses, second dose 2-6 months later

Question 6

when to discontinue pap smears?

Answer 6

age 65-70 if 3 consecutive normal cytology tests and no abnormal tests in past 10 years

Question 7

AAA screening with ultrasound indications:

Answer 7

age 65-75 years. MALES ONLY if they’ve ever smoked; selectively screen if never smoked

Question 8

what are colorectal screening recommendations?

Answer 8

age 45-75- stool based annually OR colonoscopy ever 10 years;
age 76-85- based on patient preferences, life expectancy, health status, prior screening
age 85+: discourage screening
all positive non-colonoscopy screening results should be followed up with colonoscopy screening

Question 9

what are vaccine recommendations for pneumococcal?

Answer 9

age 19-64 with certain medical conditions: 1 dose of PCV 13 (conjugate); administered before giving any recommended dose of PPSV23
age 65+ PCV 13; 1 dose after shared decision making. PPSV23 (polysaccharide)- 19-64 administer if smoke or certain medical conditions- 1-2 doses depending on medical condition
65+- 1 dose at least 1 year after PCV 13 dose, and 5 years after prior PPSV 23 doses

Question 10

when is HPV vaccination recommended?

Answer 10

age 9-14 years- 2 shots, 6 months apart
15-26 years- 3 shots 0,2,6 months
27-45 0,2,6 months after shared clinical decision making

Question 11

when is meningococcal vaccine recommended?

Answer 11

age 11-18 1 dose

revaccinate 1x for high risk: college freshman living in dorms. after 5 years from last dose

Question 12

female testing recommendations: pap, cytology, HPV co-test (cytology + HPV test combined)

Answer 12

Pap: age 21 years, discontinue at > 65 years with 3 consecutive normal cytology tests
cytology: age 30-65, every 3 years
co-test: age 30-65, every 5 years

Question 13

when is clinical breast exam recommended?

Answer 13

20-39 years: every 3 years

40+: annually

Question 14

when should BP screening begin

Answer 14

age 20, every healthcare visit, or every 2 years

Question 15

what are indications for pneumococcal vaccine age 19-64?

Answer 15

smoke, asthma, lung heart liver or kidney disease, chronic diseases; diabetes, cirrhosis, sickle cell, CSF leak, alcoholism, weak immune system: Hodgkin’s disease, lymphoma, leukemia, multiple myeloma, HIV/ AIDs, kidney failure, splenectomy, long term steroid use or immunosuppressants, living in long term care facility

Question 16

what are routine vaccines for 65+ (TIPS)

Answer 16

Tdap, Influenza, Pneumococcal, Shingles

Question 17

splenectomy vaccine recommendations

Answer 17

meningococcal vaccines (both types)
both types pneumococcal vaccines- conjugate and polysaccharide
Hib vaccine
influenza- annually
Tdap, zoster, HPV, MMR, varicella

Question 18

Mumps vaccine for healthcare workers- recommendations before vs after 1957

Answer 18

DOB before 1957- 1 dose unless evidence of immunity: positive serology or clinically diagnoses
DOB after 1957- 2 doses of vaccine, unless immunity documented-