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01 Family Medicine > USPSTF Guidelines > Flashcards

USPSTF Guidelines Flashcards

USPSTF Grade A and B Guidelines (last update 1/22/23)

1
Q

USPSTF guideline for Abdominal Aortic Aneurysm

A

1 time screening with US in men 65-75 who have ever smoked

Grade B

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2
Q

USPSTF guideline for Screening for Pre-diabetes and Type 2 Diabetes Mellitus

A

Asymptomatic adults aged 35-70 who are overweight or obese

If +, offer/refer patients to intensive behavioral counseling interventions (healthy diet and exercise)

Grade B

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3
Q

Indications for aspirin use as a preventative medication per USPSTF?

A

Grade C:
Ages 40-59 with a 10% or greater 10 year CVD risk
Use shared decision for initiating low dose ASA for the primary prevention of CVD*

*net benefit of ASA is small, also consider bleeding risk, life expectancy, willingness to take daily ASA for at least 10 years

Grade D:
Ages 60+
Recommend against initiating low dose ASA use for the primary prevention of CVD

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4
Q

USPSTF guideline for Asymptomatic Bacteriuria screening

A

Screen with urine culture for pregnant women

Grade B

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5
Q

USPSTF guideline for BRCA-Related Cancer Risk Assessment

A

Assess women with a personal or family history of breast, ovarian, tubal or peritoneal cancer or who have an ancestry associated with breast cancer susceptibility BRCA1/2 mutations with a risk assessment tool.

Women with a positive score should receive genetic counseling and if indicated after counseling, genetic testing

Tools: Ontario family hx, Manchester scoring, Referral screening tool, Pedigree Assessment, 7-Question family hx, etc.

Grade B

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6
Q

USPSTF guideline for Breast Cancer Medication Use

A

Offer to prescribe risk reducing medications (tamoxifen, raloxifene or aromatase inhibitors) to women at increased risk for breast cancer and low risk for adverse medication effects

Increased risk: Hx of LCIS or atypical hyperplasia, Gail model 5 year risk 1.66% or higher

Not for women with BRCA mutations

Grade B

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7
Q

USPSTF guideline for Breast Cancer Screening

A

Screening mammography for women 50-74 every 2 years

Grade B

For women 40-49, shared decision making

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8
Q

USPSTF guideline for Breast feeding

A

Provide interventions during pregnancy and after birth to support breastfeeding

Grade B

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9
Q

USPSTF guideline for Cervical Cancer Screening

A

21-29:
cytology (PAP smear) alone every 3 years

30-65:
HPV testing alone or HPV testing and cytology (PAP smear) every 5 years
or cytology (PAP smear) alone every 3 years

Grade A

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10
Q

USPSTF guideline for Colorectal Cancer Screening

A

Ages 45-75

FIT every year
Flex sigmoidoscopy every 5 years
Colonoscopy every 10 years

Grade A (Ages 50-75), Grade B (Ages 45-49)

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11
Q

USPSTF guideline for Dental Caries

A

6 months- 5 years old

Prescribe oral fluoride supplementation for children whose water is deficient in fluoride

Apply fluoride varnish to the primary teeth starting at age of tooth eruption

Grade B

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12
Q

USPSTF guideline for Depression in adults and pregnant women

A

Screen the general adult, pregnant and postpartum populations
Need system to diagnose, treat and follow up

Grade B

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13
Q

USPSTF guideline for Depression and Suicide Risk Screening in Kids/Teens

A

Ages 12-18
Screen for Major Depressive Disorder
Need system to diagnose, treat and follow up

Grade B

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14
Q

USPSTF guideline for Fall Prevention

A

Recommend exercise interventions to prevent falls in community dwelling older adults, 65 and older who are at increased risk for falls

Grade B

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15
Q

USPSTF guideline for Prevention of Neural Tube defects

A

All women planning or capable of pregnancy take daily folic acid (0.4 - 0.8 mg)

Grade A

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16
Q

USPSTF guideline for Gestational Diabetes screening

A

Screen for GDM in asymptomatic pregnant women at 24 weeks gestation or after

Grade B

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17
Q

USPSTF guideline for Chlamydia and Gonorrhea screening in women

A

Screen for G/C in sexually active women age 24 years and younger.

For women 25 and up, screen those at increased risk

Grade B

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18
Q

USPSTF guideline for Behavioral Interventions for Adults with CVD Risk Factors

A

Offer/refer adults with CVD risk factors to behavioral counseling interventions to promote healthy diet and physical activity

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19
Q

USPSTF guideline for Hepatitis B Screening

A

Screen for HBV in adolescents and adults at increased risk
(Grade B)

Screen for HBV in pregnant women at their first prenatal visit
(Grade A)

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20
Q

USPSTF guideline for Hepatitis C Screening

A

Screen for HCV in adults aged 18-79

Grade B

21
Q

USPSTF guideline for HIV Screening

A

Screen all pregnant women, including those who present in labor with unknown HIV status
(Grade A)

Screen adolescents and adults 15-65 or those at increased risk.
(Grade A)

22
Q

USPSTF guideline for High Blood Pressure Screening

A

Screen in adults 18 and older

Obtain measurements outside of clinical setting for diagnostic confirmation before starting treatment. Ambulatory Blood Pressure Monitoring is preferred

Grade A

23
Q

USPSTF guideline for Screening for Intimate partner violence, Elder Abuse, and Abuse of Vulnerable adults

A

Screen for intimate partner violence in women of reproductive age, if positive refer to support services
(Grade B)

Insufficient evidence in screening all adults and elders

24
Q

USPSTF guideline for Latent TB Screening

A

Screen for LTBI in at risk patients

Risks: Born or resided in countries with increased TB prevalence, lived in high risk setting like homeless shelters or jail, immunosuppressed

Grade B

25
USPSTF guideline for Preeclampsia prevention
Use low dose Aspirin (81 mg daily) as preventative medication, starting after 12 weeks gestation in women at high risk for preeclampsia Grade B
26
USPSTF guideline for Lung Cancer Screening
Annual screening with low dose CT scan in adults 50-80 who have a 20 pack year smoking hx and currently smoke or who have quit within the past 15 years. Discontinue screening when the person has not smoked for more than 15 years, or develops a problem that lowers life expectancy or would limit their ability to have curative lung surgery Grade B
27
USPSTF guideline for Obesity screening in kids and teens
Screen children 6 years and older Offer/refer to intensive behavioral interventions to improve weight status Grade B
28
USPSTF guideline for Ocular prophylaxis for Gonococcal Ophthalmia Neonatorum
Use prophylactic ocular topical medication for all newborns Grade A
29
USPSTF guideline for Osteoporosis Screening
Screen all women 65 years and older with bone measurement testing to prevent osteoporotic fractures Screen postmenopausal women younger than 65 years who are at increased risk (ex: FRAX score) Grade B
30
USPSTF guideline for Perinatal Depression Screening
Provide/refer pregnant and postpartum women who are at increased risk for depression to counseling interventions Grade B
31
USPSTF guideline for Preeclampsia Screening
Screen by getting blood pressure measurements throughout pregnancy Grade B
32
USPSTF guideline for Prevention of HIV
Offer preexposure prophylaxis with effective antiretroviral therapy to persons at high risk Grade A
33
USPSTF guideline for Prevention and Cessation of Tobacco Use
Children and Adolescents: education, counseling to prevent initiation of use Adults: ask about use, advise to stop use, provide behavioral interventions and FDA approved pharmacotherapy for cessation Pregnant women: ask about use, advise to stop use, provide behavioral interventions for cessation Grade B, A, A
34
USPSTF guideline for Rh(D) Incompatibility Screening
Use Rh(D) blood typing and antibody testing for all pregnant women during their first visit Repeat Rh(D) antibody testing for all unsensitized Rh(D) negative women at 24-28 weeks gestation, unless the biological father is known to be Rh(D) negative Grade B
35
USPSTF guideline for STI Counseling
Behavioral counseling for all sexually active adolescents and adults who are at increased risk for STIs Grade B
36
USPSTF guideline for Skin Cancer Prevention
Counsel adults, kids, teens and parents about minimizing exposure to UV radiation for persons 6 months to 24 years with fair skin types to reduce the risk of skin cancer Grade B
37
USPSTF guideline for Statin Use for the Primary Prevention of CVD in adults
Adults with no CVD history (primary prevention) start statin therapy if all 3 criteria are met: 1) ages 40-75 2) 1 or more CVD risk factors (dyslipidemia, HTN, DM, smoking) 3) 10 year ASCVD risk 10% or greater (Grade B) *If ASCVD risk in same population is 7.5-9.9% the recommendation becomes Grade C as the likelihood of benefit of statin therapy is smaller
38
USPSTF guideline for Syphilis Screening
Screen all pregnant women and anyone at increased risk Grade B
39
USPSTF guideline for Unhealthy Alcohol Use Screening
Screen all adults 18 and older (including pregnant women) Provide brief behavioral counseling interventions to reduce unhealthy use AUDIT-C, CAGE Grade B
40
USPSTF guideline for Unhealthy Drug Use
Screen all adults 18 and older (using questions not urine/blood testing) Provide services for diagnosis, treatment, care NIDA quick screen Grade B
41
USPSTF guideline for Vision Screening
Screen at least once in all children ages 3-5 years old to detect amblyopia or risk factors Grade B
42
USPSTF guideline for Weight Loss
Offer/refer adults with BMI 30 or greater to intensive, multicomponet behavioral interventions Grade B
43
USPSTF guideline for Thyroid Screening
Insufficient evidence to screen nonpregnant, asymptomatic adults Grade I
44
USPSTF guideline for Prostate Cancer Screening
For men aged 55 to 69 years: shared decision making Screening offers a small potential benefit of reducing the chance of death from prostate cancer in some men. Potential harms of screening: including false-positive results that require additional testing and possible prostate biopsy; overdiagnosis and overtreatment; and treatment complications, such as incontinence and erectile dysfunction. Clinicians should not screen men who do not express a preference for screening or are over age 70 Grade C, D
45
What are the high and moderate risk factors for Preeclampsia?
Risks: High: hx of pre-e, multifetal gestation, chronic HTN, T1 or T2 DM, Renal disease, Autoimmune (SLE, antiphospholipid) Moderate: nulliparity, obesity, family hx of pre-e, >35 years, AA, low SES, SGA, low birth weight, >10 years between pregnancies, previous adverse outcomes
46
USPSTF guideline for Hypertension Screening in adults
Screen for hypertension in adults 18 years or older with office blood pressure measurement (OBPM). The USPSTF recommends obtaining blood pressure measurements outside of the clinical setting for diagnostic confirmation before starting treatment. Grade A
47
USPSTF guideline for Healthy weight gain in pregnancy
Offer pregnant persons effective behavioral counseling interventions aimed at promoting healthy weight gain and preventing excess gestational weight gain in pregnancy. Grade B
48
USPSTF guideline for screening for anxiety in children and adolescents
Screen for anxiety in ages 8-18 Grade B
49
Risk factors for Hepatitis B?
Risks: Born in a country with high prevalence (>2%) mostly perinatal transmission Increased risk during birth or early childhood for kids born in the US but have parents from an area of high prevalence, especially if no immunoprophylaxis or perinatal antiviral therapy was given IV drug users, men who have sex with men, HIV positive, household contacts of a known HBsAg positive person

01 Family Medicine (16 decks)

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