USPSTF Guidelines Flashcards
What is the main focus of primary prevention, and what is an example?
preventing disease in the first place - immunizations
What is the main focus of secondary prevention, and what is an example?
screening for asymptomatic disease (the patient comes in and has no complaint of symptoms) - mammograms, colonoscopies
What is the main focus of tertiary prevention, and what is an example?
preventing complications from symptomatic disease - diabetes management
What guidelines should be used for average risk asymptomatic individuals in a primary care setting?
USPSTF guidelines for adequate screenings
What screening services are 100% covered by all insurances under the ACA?
A and B level recommendations
How are screening decisions made?
- does it lessen the burden of suffering
- how good is the screening test
- does it provide adequate prevention
What are some harms that can be associated with screening?
risks associated with the screening test anxiety over diagnosis additional diagnostic testing be aware of limited benefit with certain comorbidities
What is the guideline for carotid artery stenosis screening?
Grade D
What are the guidelines for hypertension?
Grade A: everyone over 18
blood pressure is taken at every visit anyway
What are the guidelines for hypertension in children and adolescents?
AAP: 3 years and older, every health care episode
NHLB: 3-17 years old annually
bright futures AHA: during annual well child visits beginning at age 3
What are the screening guidelines for hyperlipidemia/high cholesterol?
under age 20 insufficient evidence
age 40-75 with no history of cv disease, but at least 1 CVD risk factor (over 10%) - they should be put on a statin/cholesterol medication = Grade B
age 76+ with no history of CVD insufficient evidence
What is the guideline for coronary heart disease?
if their is no history of CHD - insufficient evidence
using an EKG for low risk adults is a grade D
What is the guideline for abdominal aortic aneurysm in men?
65-75 year olds who had smoked = Grade B
65-75 year olds never smoked = Grade C
What is the guidelines for abdominal aortic aneurysm for women?
65-75 who smoked - insufficient evidence
65-75 if they never smoked = Grade D
What are the guidelines for peripheral artery disease?
risk assessment with ankle brachial index indicates insufficient evidence
What is the guideline for aspirin prophylaxis for a person 50-59 years old?
50-59 year olds = grade B, if they have a greater than 10% 10 year CVD risk, not at risk for bleeding, life expectancy of at least 10 years, willing to take daily
What is the guideline for aspirin prophylaxis for a person 60-69 years old?
age 60-69 with a greater than 10% 10 year CVD risk = Grade C
What is the guideline for aspirin under 50 or over 70 years old?
insufficient evidence
What is the guideline for colorectal cancer?
adults age 50-75 = Grade A
adults age 76-85 = Grade C
What is the guideline for prostate cancer?
Grade D
What are the harms associated with prostate cancer screening?
false positives,
biopsy side effects
overtreatment
side effects from treatment
What are the current USPSTF draft recommendations for prostate screening?
Grade C age 55-69
Grade D men 70+
What are the guidelines for skin cancer?
insufficient evidence
What are the USPSTF guidelines for breast cancer?
40-49 Grade C
50-74 Grade B
What are the ACOG guidelines for breast cancer?
every year 40-74
over 75 individualize
What is the USPSTF guidelines for cervical cancer?
screen women at 21-65 (Grade A)
do not screen under 21
do not test for HPV under 30 (Grade D)
What is the guideline for lung cancer?
adults 55-80 with a history of smoking Grade B
can get a CT if there is a 30 pack year history, or has quit in the last 15 years
What is the guideline for chlamydia?
Grade B for sexually active women under 24, and older women at risk
insufficient evidence for men
What is the guideline for Hep B?
Grade B = people at high risk
Grade A = pregnant women at first prenatal visit
What is the guideline for Hep C?
Grade B = people at high risk and offer 1 time screening for baby boomers
no guideline for adoslescents and adults
What is the guideline for HIV?
Grade A = screen adolescents and adults 15-65, screen others if they are at risk
Grade A = all pregnant women
What is the guideline for syphillis?
asymptomatic, non pregnant adults and adolescents at increase risk = Grade A
pregnant women = Grade A
What is the guideline for depression?
Grade B for general adult population
Grade B for adolescents 12-18
What is the guideline for depression in children under 11?
insufficient evidence
What is the guideline for tobacco?
Grade A = ask all adults including pregnant women about tobacco use and advise against it
What is the guideline for tobacco use in children?
Grade B = provide interventions including education
What is the guideline for alcohol?
Grade B = screen adults over 18 for alcohol misuse and provide brief behavioral interventions
What is the guideline for alcohol in people under 18?
insufficient evidence
What is the guideline for drug abuse?
insufficient evidence
What is the guideline for intimate partner violence?
grade B for women of childbearing age
What is the guideline for intimate partner violence in elderly?
insufficient evidence
What is the guideline for thyroid disorders?
insufficient evidence
What is the guideline for thyroid cancer?
Grade D
What is the guideline for osteoporosis?
women over 65 and younger women whose risk is equal or greater than a 65 year old white woman = Grade B
What is the guideline for osteoporosis in men?
insufficient evidence
What is the guideline for obesity?
Grade B = screen all adults, or refer pateints with a BMI over 30 to behavioral interventions
Grade B for children and adolescents
What is recommended for vision?
insufficient evidence for glaucoma
insufficient evidence for sight loss over 65
Grade B - screening once for children 3-5 for amblyopia
What is the guideline for hearing?
insufficient evidence
