Screening Recommendations Flashcards

1
Q

What fields are represented in USPSTF?

A

Preventative medicine, primary care, internal medicine, family medicine, beds, behavioral health, OB, nursing

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2
Q

Category A

A

Recommended service-high certainty that the net benefit is substantial

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3
Q

Category B

A

Recommended service-high certainty that benefit is moderate or moderate-substantial

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4
Q

Category C

A

Service is recommended selectively or based on professional judgement/patient preference

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5
Q

Category D

A

Recommended to NOT do the service, risk outweighs benefit

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6
Q

Category I

A

Insufficient evidence

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7
Q

How are screening decisions made?

A

Burden of suffering, sensitivity/specificty/safety of test, prevention effectiveness

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8
Q

Burden of suffering (the D’s)

A

Death, disease, disability, discomfort, dissatisfaction,destitution

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9
Q

Harms of screening

A

Risks associated with the test, anxiety, additional diagnostic testing, over-diagnosis, limited benefit

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10
Q

Cardiovascular Disease screening tests

A

Hypertension, hyperlipidemia, coronary heart disease, carotid artery stenosis, abdominal aortic aneurysm, peripheral artery disease, aspirin prophylaxis

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11
Q

What is considered increased 10-year CVD risk?

A

> 7.5%

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12
Q

Hypertension

A

Grade A for 18+, screen every 3-5 years until age 40, then annually

Annually if at increased risk (high BP, obese, African American)

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13
Q

Hypertension Children/adolescents

A

AAP: >3 years old at every health care episode

NHLB, bright futures, AHA: annually beginning at age 3

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14
Q

Hyperlipidemia

A

Primary prevention- low-mod dose statin Grade B: age 40-75, no hx of CVD, >1 CVD risk factor &10 year risk >10%

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15
Q

Coronary Heart Disease

A

hs-CRP, ankle-brachial index, coronary artery calcification score with no hx-insufficient evidence

EKG-Grade D

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16
Q

Carotid Artery Stenosis

A

Grade D- only 10% ischemic stroke caused by CAS, 1% of CAS are asymptomatic

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17
Q

Abdominal Aortic Aneurysm

A

Men-Grade B if 65-75 who’ve ever smoked

Women- Grade D who’ve never smoked, insufficient evidence if they have smoked

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18
Q

Peripheral Artery Disease

A

Insufficient evidence

19
Q

Aspirin Prophylaxis

A

Grade B: 50-59 w/ >10% 10 year risk, no risk of bleeding, life expectancy at least 10 years, willing to take daily for 10 years

20
Q

Types of Cancers

A

Colorectal, prostate, skin, breast, cervical, lung

21
Q

Colorectal Cancer

A

Grade A:50-75 years old

Grade C: 76-85, if healthy enough for treatment

22
Q

Prostate Cancer

A

Grade D 70+

Grade C 50-69 after discussing risk/benefits

23
Q

Skin Cancer

A

Grade B recommendation for counseling 6 months-24 years

Otherwise insufficient

24
Q

Breast Cancer

A

Grade B: every 2 years 50-74
Grade C: 40-49

ACOG: offer at 40, start no later than 50; every 1-2 years until 75

25
Q

Cervical Cancer

A

Grade A: women 21-65 every 3 years w/pap alone, 30-65 every 5 w/ HPV testing

DO NOT TEST for HPV under 30

26
Q

Lung Cancer

A

Grade B: 55-80 with hx of smoking-annually w/ 30pack year hx and quit w/in last 15 years

27
Q

Cancer

A

Assess hereditary risk

28
Q

STI’s

A

Chlamydia/gonorrhea, Hep B, Hep C, HIV, Syphilis

29
Q

Chlamydia/gonorrhea

A

Grade B: sexually active women <24 and older women if increased risk

30
Q

Hep B

A

Grade A: pregnant women @ first prenatal visit

Grade B: anyone high risk

31
Q

Hep C

A

Grade B: high risk; offer once to baby boomers (1945-1965)

32
Q

HIV

A

Grade A: 15-65, younger if increased risk, all pregnant women

33
Q

Syphilis

A

Grade A: asymptomatic, anyone at risk, early in pregnant women

34
Q

Psychosocial Health Concerns

A

Depression, substance related, intimate partner violence

35
Q

Depression

A

Grade B: general adults, pregnant &postpartum

Grade B for major depressive disorder in 12-18

36
Q

Substance Related

A

Grade A: ask all adults for tobacco & drug use

Grade B: anyone >18 for alcohol; provide intervention/education in children for tobacco

37
Q

Intimate Partner Violence

A

Grade B: women of reproductive age, refer to ongoing support if positive

38
Q

Endocrine Disorders

A

Thyroid, osteoporosis, obesity

39
Q

Thyroid

A

Grade D: thyroid cancer

Dysfunction is insufficient

40
Q

Osteoporosis

A

Grade B: women >65 w/bone measurement testing; postmenopausal women <65 at increased risk

Insufficient for men

41
Q

Obesity

A

Grade B: BI >30 refer to behavior intervention; children >6 screen and refer

42
Q

Vision

A

Grade B: 3-5 years old for amblyopia

Insufficient otherwise

43
Q

Hearing

A

Insufficient in asymptomatic over 50

44
Q

Injury Prevention

A

Grade B: Exercise intervention to prevent falls over 65

Grade D: no vit D supplementation to prevent falls