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Firelands Family Med > USPSTF Screening Guidelines > Flashcards

USPSTF Screening Guidelines Flashcards

1
Q

Grade A

A

Recommends- high certainty that net benefit is substantial

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2
Q

Grade B

A

Recommends- high certainty that net benefit is moderate

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3
Q

Grade C

A

Selectively offer this service on individual basis, net benefit is small

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4
Q

Grade D

A

Recommend against- no benefit or harm outweighs benefit

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5
Q

Grade I

A

insufficient evidence to assess risks/benefits

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6
Q

Atrial Fib: screening adults with EKG

A

Grade I: insufficient evidence

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7
Q

Abdominal aortic aneurysm: screening adults

  • men age 65-75 who have ever smoked
  • men age 65-75 who have never smoked
  • women age 65-75 who have ever smoked
  • women who have never smoked
A

M smokers 65-75: Grade B- one lifetime U/S
M nonsmokers 65-75: Grade C- selectively offer
F smokers 65-75: Grade I- insufficient evidence
F nonsmokers: Grade D- recommend against

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8
Q

Abnormal blood glucose and DM2: screening adults

A

Grade B: screen adults age 40-70 who are overweight or obese.

  • Promote healthy diet and physical activity.
  • If obvious signs of diabetes, screen regardless.
  • If + fmhx or PCOS or gestation DM or minority race then screen earlier.
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9
Q

Adolescent idiopathic scoliosis

A

Grade I: insufficient evidence for screening ages 10-18

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10
Q

Aspirin to prevent CVD and colon cancer: screening adults

  • age < 50
  • age 50-59 with > 10% 10 year CVD risk
  • age 60-69 with > 10% 10 year CVD risk
  • age > 70
A
  • age < 50: Grade I- insufficient evidence
  • age 50-59 with > 10% risk: Grade B- initiate low dose ASA for primary prevention of CVD and colon cancer if no increased risk of bleed, life expectancy > 10 years, willing to take for at least 10 years
  • age 60-69 with > 10% risk: Grade C- weigh risks and benefits on individual basis, selectively offer
  • age > 70: Grade I- insufficient evidence
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11
Q

Asymptomatic bacteriuria: screening adults

  • pregnant women
  • men and non pregnant women
A
  • pregnant women: Grade A- urine culture at 12-16 weeks or first prenatal visit if later
  • men and non pregnant women: Grade D- recommend against
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12
Q

Autism spectrum disorder: screening in children

A

Grade I- insufficient evidence to screen children 18-30 months for whom no concerns of ASD have been raised by parents or clinician

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13
Q

Bacterial vaginosis in pregnancy: screening to prevent preterm delivery

  • asymptomatic pregnant women with low risk
  • asymptomatic pregnant women with high risk
A
  • asymptomatic pregnant F with low risk: Grade D- recommend against
  • asymptomatic pregnant F with high risk: Grade I- insufficient evidence
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14
Q

Bladder cancer: screening in adults

A

Grade I- insufficient evidence to screen asymptomatic adults

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15
Q

Blood pressure: screening in children and adolescents

A

Grade I- insufficient evidence to support screening in asymptomatic children and adolescents

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16
Q

BRCA related cancer: risk assessment, genetic counseling, and genetic testing

  • Women with family members affected family members
  • Women with no fmhx
A
  • WITH fmhx: Grade B- screen women with fmhx breast, ovarian, tubal, or peritoneal cancer with one of several screening tools. If positive screening results then refer to genetic counseling. If indicated after counseling, then BRCA test.
  • WITHOUT fmhx: Grade D- recommend against routine genetic counseling or BRCA testing
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17
Q

Breast cancer: medications for risk reduction

  • women at increased risk
  • women at no increased risk
A
  • women at increased risk: Grade B- shared decision making, if benefits outweigh risks then offer meds such as tamoxifen/raloxifene
  • women at no increased risk: Grade D- recommend against routine use
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18
Q

Breast cancer: screening

  • women age 40-49
  • women age 50-74
  • women age > 75
  • digital breast tomosynthesis (DBT)
  • women with dense breasts
A
  • age 40-49: Grade C- screen selectively
  • age 50-74: Grade B- recommend biennial screening mammogram
  • age > 75: Grade I
  • digital breast tomosynthesis: Grade I for primary screening method
  • women with dense breasts: Grade I for adding imaging such as U/S, MRI, DBT if mammogram negative
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19
Q

Breastfeeding: primary care interventions

A

Grade B: recommend providing interventions during pregnancy and after birth to support breastfeeding

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20
Q

Cardiovascular disease risk: screening adults with EKG

  • adults at low risk of CVD events
  • adults with intermediate-high risk of CVD events
A
  • low risk adults: Grade D- recommend against screening resting or exercise EKG in asymptomatic adults
  • intermediate-high risk adults: Grade I- insufficient evidence for resting or exercise EKG in asymptomatic adults
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21
Q

Cardiovascular disease: adult risk assessment with nontraditional risk factors

A

Grade I- insufficient evidence to assess harms and benefits of adding ankle-brachial index, high sensitivity CRP level, or coronary artery calcium score to traditional risk assessment for CVD in asymptomatic adults

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22
Q

Carotid artery stenosis: screening in adults

A

Grade D- recommend against screening for asymptomatic carotid artery stenosis in general adult population

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23
Q

Celiac disease: screening

A

Grade I- insufficient evidence to assess pros/cons of screening for celiac disease in asymptomatic adults, adolescents, or children

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24
Q

Cervical cancer: screening

  • age < 21
  • age 21-65
  • age > 65
  • hx hysterectomy
A
  • age < 21: Grade D- recommend against
  • age 21-65: Grade A- For age 21-29 screen for cervical cancer Q3Y with cytology alone. For age 30-65 screen Q3Y with cytology alone, every 5 years with hrHPV alone, or Q5Y with cotesting.
  • age >65: Grade D- recommend against
  • hx hysterectomy: Grade D- recommend against if no cervix and no hx CIN2/3 or cervical cancer
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25
Q

Child maltreatment: interventions

A

Grade I- insufficient evidence to assess primary care interventions in maltreatment. Still report per state laws.

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26
Q

Chlamydia and gonorrhea: screening

  • chlamydia in sexually active women
  • gonorrhea in sexually active women
  • sexually active men
A
  • chlamydia F: Grade B- screen in sexually active women < 24 years or older if and increased risk
  • gonorrhea F: Grade B- screen in sexually active women < 24 years or older if increased risk
  • M: Grade I- insufficient evidence for chlamydia or gonorrhea
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27
Q

COPD: screening

A

Grade D: don’t screen asymptomatic adults

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28
Q

Cognitive impairment in adults: screening

A

Grade I: insufficient evidence

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29
Q

Colorectal cancer: screening

  • adults age 50-75
  • adults age 76-85
A
  • age 50-75: Grade A- start screening at age 50
  • age 76-85: Grade C- individual decision, consider that would benefit most if never screened before. Also should be healthy enough and have life expectancy such that they would benefit from treatment if cancer found.
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30
Q

Dental caries in children (birth- age 5): screening

  • prescription of oral fluoride supplementation
  • application of fluoride varnish
  • dental screening exams by PCP
A
  • Grade B: recommend PCP prescribe oral fluoride supplementation starting age 6 months for children whose water supply is deficient
  • Grade B: recommend PCP apply fluoride arnish to primary teeth of infants/children starting at age of primary tooth eruption
  • Grade I: insufficient evidence of screening dental exams by PCP
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31
Q

Depression in adults: screening

A

Grade B: Screen for depression in the general adult population, including pregnant and postpartum women. Screening should be implemented with adequate systems in place to ensure accurate diagnosis, effective treatment, and appropriate f/u.

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32
Q

Depression in children and adolescents: screening

  • age < 11
  • age 12-18
A
  • age < 11 years: Grade I- insufficient evidence

- age 12-18: Grade B- screen with adequate systems in place to ensure accurate dx, effective tx, and appropriate f/u

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33
Q

Drug use, illicit: primary care interventions for children and adolescents

A

Grade I: insufficient evidence to primary care interventions. Does not apply to those already diagnosed with substance abuse disorder.

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34
Q

Drug Use, Illicit: Screening

A

Grade I: insufficient evidence to support screening adolescents, adults, and pregnant women

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35
Q

Falls Prevention in Community Dwelling Older Adults: Interventions

  • exercise interventions age > 65
  • multifactorial interventions age > 65
  • vitamin D age > 65
A
  • Exercise interventions: Grade B- recommend
  • Multifactorial: Grade C- consider with patient
  • Vitamin D: Grade D- recommend against
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36
Q

Folic Acid for prevention of Neural Tube Defects: preventative medicine

A

Grade A: recommend daily supplement containing 0.4-0.8 mg folic acid to all women planning or capable of pregnancy

37
Q

Genital Herpes Infection: Serologic Screening

A

Grade D: recommend against routine serologic screening for genital HSV in asymptomatic adolescents, adults, and pregnant women

38
Q

Gestational Diabetes Mellitus: Screening

  • asymptomatic pregnant F < 24 weeks
  • asymptomatic pregnant F > 24 weeks
A
  • F < 24 weeks: Grade I

- F > 24 weeks: Grade B

39
Q

Glaucoma: Screening

A

Grade I: insufficient evidence to screen for primary open-angle glaucoma

40
Q

Gynecological Conditions: Periodic Screening With the Pelvic Examination

A

Grade I: insufficient evidence for screening pelvic exams in asymptomatic women for early detection and treatment of a range of gynecologic conditions. Does not apply to screening for cervical cancer, gonorrhea, or chlamydia.

41
Q

Healthful Diet and Physical Activity for Cardiovascular Disease Prevention in Adults with Cardiovascular Risk Factors: Behavioral Counseling

A

Grade B: recommends offering or referring adults who are overweight or obese and have additional CVD risk factors to intensive behavioral counseling interventions to promote a healthful diet and physical activity for CVD prevention

42
Q

Healthful Diet and Physical Activity for CVD Prevention in Adults without Known Risk Factors: Behavioral Counseling

A

Grade C: individualize the decision if patient has no HTN, dyslipidemia, abnormal glucose, diabetes

43
Q

Hearing Loss in Older Adults: Screening

A

Grade I: insufficient evidence for screening adults > 50 if asymptomatic

44
Q

Hepatitis B in Pregnant Women: Screening

A

Grade A: recommend screening for HBV in pregnant women at first prenatal visit

45
Q

Hepatitis B Virus Infection: Screening

A

Grade B: recommend screening for HBV in persons at high risk for infection

46
Q

Hepatitis C: Screening

A

Grade B: recommends screening for HCV infections in persons at high risk. Offer one time screening for adults born between 1945-1965.

47
Q

High Blood Pressure in Adults: Screening

A

Grade A: recommend screening age > 18. Recommend obtaining BP readings outside of clinical setting for diagnostic confirmation before starting treatment

48
Q

Hormone Therapy in Postmenopausal Women: Primary Prevention of Chronic Conditions

  • postmenopausal women
  • postmenopausal women with hx hysterectomy
A
  • postmenopausal women: grade D- recommend against use of combined estrogen/progestin for primary prevention of chronic conditions
  • hx of hysterectomy: Grade D- recommend against use of estrogen alone for primary prevention of chronic conditions
49
Q

HIV Infection: Screening

  • adolescents and adults 15-65
  • pregnant women
A
  • adolescents and adults 15-65: Grade A- recommend screening, screen younger if at increased risk
  • pregnant women: Grade A- recommend screening all pregnant women, including those who present in labor and are untested or status unknown
50
Q

Impaired Visual Acuity in Older Adults: Screening

A

Grade I

51
Q

Intimate Partner Violence, Elder, Abuse, and Abuse of Vulnerable Adults: Screening

  • women of reproductive age
  • other or vulnerable adults
A
  • F of reproductive age: Grade B- screen and provide/refer for ongoing support
  • other vulnerable adults: Grade I- insufficient evidence for screening for abuse/neglect of older/vulnerable adults
52
Q

Iron Deficiency Anemia in Pregnant Women: Screening and Supplementation

  • screening for iron deficiency in pregnancy
  • supplemental iron in pregnancy
A
  • screening: Grade I

- supplemental iron: Grade I

53
Q

Iron Deficiency Anemia in Young Children: Screening

- age 6-24 months

A

Grade I

54
Q

Latent Tuberculosis Infection: Screening

A

Grade B: recommend screening for latent TB in populations at risk

55
Q

Lead Levels in Children and Pregnancy: Screening

  • asymptomatic kids age 1-5 at increased risk
  • asymptomatic kids age 1-5 at average risk
  • asymptomatic pregnant women
A
  • age 1-5 at increased risk: Grade I
  • age 1-5 at average risk: Grade D
  • pregnant women: Grade D
56
Q

Lipid Disorders in Children and Adolescents: Screening

A

Grade I for 20 years and younger

57
Q

Low-Dose Aspirin Use for the Prevention of Morbidity and Mortality from Preeclampsia: Preventative Medicine

A

Grade B: recommend 81 mg aspirin per day as preventive medication after 12 weeks gestation in women who are at high risk for preeclampsia

58
Q

Lung Cancer: Screening

A

Grade B: recommend annual screening for lung cancer with low-dose CT in adults age 55-80 who have a 30 pack year smoking history and currently smoke or have quit within the past 15 years. Discontinue screening once a person has not smoked for 15 years or develops a health problem that substantially limits life expectancy or ability or willingness to have curative lung surgery

59
Q

Obesity in Children and Adolescents: Screening

A

Grade B: recommend screening for obesity > age 6and offer/refer for comprehensive, intensive behavioral interventions to promote improvements in weight status

60
Q

Obstructive Sleep Apnea in Adults: Screening

A

Grade I for asymptomatic adults

61
Q

Ocular Prophylaxis for Gonococcal Ophthalmia Neonatorum: Preventative Medication

A

Grade A: recommend prophylactic ocular topical medication for all newborns to prevent gonococcal ophthalmia neonatorum

62
Q

Oral Cancer: Screening

A

Grade I for asymptomatic adults

63
Q

Osteoporosis to Prevent Fractures: Screening

  • women > 65
  • postmenopausal women < 65 at increased risk
  • men
A
  • F > 65: Grade B- recommend screening with bone measurement testing
  • postmenopausal F < 65 with risk: Grade B- recommend as determined by a formal clinical risk assessment tool
  • men: Grade I
64
Q

Ovarian cancer: screening

A

Grade D: recommend against screening asymptomatic women not known to have a high risk hereditary cancer syndrome

65
Q

Pancreatic Cancer: screening

A

Grade D: recommend against screening in asymptomatic adults using abdominal palpation, ultrasound, or serologic markers

66
Q

Perinatal Depression: Preventive Interventions

A

Grade B: recommend providing/referring pregnant and postpartum persons at increased risk to counseling interventions

67
Q

Peripheral Artery Disease and Cardiovascular Disease: Screening and Risk Assessment with Ankle-Brachial Index

A

Grade I for asymptomatic adults

68
Q

Preeclampsia: Screening

A

Grade B: recommend screening for preeclampsia in pregnant women with BP measurements throughout pregnancy

69
Q

Prostate Cancer: Screening

  • men age 55-69
  • men > 70
A
  • men 55-69: Grade C- weigh pros/cons and make individual decision with patient
  • age > 70: Grade D- recommend against screening with PSA
70
Q

Rh(D) Incompatibility: Screening

  • pregnant women
  • unsensitized pregnant women
A
  • pregnant women: Grade A: recommend blood typing and antibody testing for all pregnant women during first visit for pregnancy-related care
  • unsensitized pregnant women: Grade B- recommend repeated Rh(D) antibody testing for all unsensitized (RhD negative) women at 24-28 weeks gestation, unless biological father known to be Rh(D) negative
71
Q

Sexually Transmitted Infections: Behavioral Counseling

A

Grade B: recommend intensive behavioral counseling for all sexually active adolescents and adults at increased risk for STIs

72
Q

Skin Cancer Prevention: Behavioral Counseling

  • young adults, adolescents, children, parents of young children
  • age > 24 with fair skin types
  • adults
A
  • kids to young adults: Grade B- recommend counseling about minimizing exposure to UV radiation to people age 6-24 with fair skin types to reduce risk of skin cancer
  • age > 24 with fair skin: Grade C- net benefit is small, consider risk factors for skin cancer
  • adults: Grade I- insufficient evidence to counsel about skin self-exams to prevent skin cancer
73
Q

Skin Cancer: Screening

A

Grade I: insufficient evidence for pros/cons of visual skin exam by clinician to screen for skin cancer in adults

74
Q

Speech and Language Delay and Disorders in Children Age 5 or Younger: Screening

A

Grade I: insufficient evidence to screen for speech and language delay/disorder

75
Q

Statin Use for the Primary Prevention of CVD in Adults: Preventive Medication

  • age 40-75 with no hx CVD, 1 or more CVD risk factors, and 10 year ASCVD risk 10% or more
  • age 40-75 with no hx CVD, 1 or more CVD risk factors, and 10 year ASCVD risk 7.5-10%
  • age > 76 years with no hx CVD
A
  • Grade B: recommend low-moderate use of statin for prevention of CVD events and mortality. Requires universal lipid screening
  • Grade C: consider on individual basis
  • Grade I: insufficient evidence in age > 76 without hx of heart attack or stroke
76
Q

Suicide Risk in Adolescents, Adults, and Older Adults: Screening

A

Grade I

77
Q

Syphilis Infection in Nonpregnant Adults and Adolescents: Screening

A

Grade A: recommend screening for syphilis in those at increased risk

78
Q

Testicular Cancer: Screening

A

Grade D: recommend against screening in adolescent or adult men

79
Q

Syphilis Infection in Pregnant Women: Screening

A

Grade A: recommend early screening for all pregnant women

80
Q

Thyroid Cancer: Screening

A

Grade D: recommend against screening in asymptomatic adults

81
Q

Thyroid Dysfunction: Screening

A

Grade I: insufficient evidence for screening non pregnant asymptomatic adults

82
Q

Tobacco Smoking Cessation in Adults, Including Pregnant Women: Behavioral and Pharmacotherapy Interventions

  • non pregnant adults
  • pregnant women
A
  • non pregnant adults: Grade A- recommend asking about smoking and advising cessation, provide behavioral interventions and FDA approved pharmacotherapy
  • pregnant women: Grade A- recommend asking, advising cessation, providing behavioral interventions
  • pregnant women: Grade I- insufficient evidence for pharmacotherapy
  • all adults: Grade I- insufficient tevidence to recommend electronic nicotine delivery systems, provide other options
83
Q

Tobacco Use in Children and Adolescents: Primary Care Interventions

A

Grade B- recommend clinicians provide interventions, including education or brief counseling, to prevent initiation of tobacco use among school-aged children and adolescents

84
Q

Unhealthy Alcohol Use in Adolescents and Adults: Screening and Behavioral Counseling Interventions

  • age > 18, including pregnant
  • age 12-18
A
  • age > 18 or pregnant: Grade B- recommend screening for unhealthy alcohol use and providing brief behavioral counseling interventions to reduce unhealthy alcohol use
  • age 12-17: Grade I
85
Q

Vision in Children Age 6 Months to 5 Years: Screening

  • age 3-5 years
  • < 3 years
A
  • age 3-5 years: Grade B- recommend vision screening at least once to detect amblyopia or its risk factors
  • < 3 years: Grade I
86
Q

Vitamin D Deficiency: Screening

A

Grade I for community-dwelling, non pregnant, asymptomatic adults > 18 years

87
Q

Vitamin D, Calcium, or Combined Supplementation for the Primary Prevention of Fractures in Community-Dwelling Adults: Preventive Medication

  • men and premenopausal women
  • postmenopausal women
A
  • men and premenopausal women: Grade I for vitamin D and calcium supplementation alone or combined for primary prevention of fractures
  • postmenopausal women: Grade I- insufficient evidence for doses greater than 400 IU vitamin D and greater than 1000 mg calcium for primary prevention fractures
  • postmenopausal women: Grade D- recommend against daily supplementation with 400 IU or less of vitamin D and 1000 mg or less calcium for primary prevention fracture
88
Q

Vitamin Supplementation to Prevent Cancer and CVD: Preventive Medicine

  • use of MV to prevent CVD or cancer
  • nutrient supplements for prevention of CVD or cancer
  • beta-carotene or vitamin E for prevention of CVD or cancer
A
  • MV: Grade I
  • single or paired nutrient supplements: Grade I
  • beta-carotene or vitamin E: Grade D
89
Q

Weight Loss to Prevent Obesity-Related Morbidity and Mortality in Adults: Behavioral Interventions

A

Grade B: recommend offering or referring adults with BMI > 30 to intensive, multicomponent behavioral interventions

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