Screening Secrets
At what age does USPSTF recommend starting average-risk colorectal screening?
45
USPSTF recommends beginning average-risk colorectal cancer screening at age 45 (recommended ages 45–75).
What two labs must be checked before starting a statin, per guidelines?
Liver enzymes & lipid panel
For an adult with T2DM + albuminuria, which class is recommended to slow CKD progression?
SGLT2 inhibitors
ADA/KDIGO: SGLT2 inhibitors are recommended to reduce CKD progression and CV events in patients with T2DM and CKD; ADA 2025 and KDIGO 2022 guidance specifically support SGLT2s for renal protection (with eGFR caveats).
Age to give Shingrix
50 or older
Most common cause of injury-related death in adults 65 or older
Fall
At what age to stop screening for pap smears according to USPSTF?
65
Stop at 65 if adequate prior screenings and not high risk
KDIGO 2021 BP target for most adults with CKD.
KDIGO 2021: suggest treating to a standardized SBP target <120 mmHg (when tolerated) for adults with CKD — with caveats about standardized measurement and patient tolerance.
According to ADA guidelines when should continuous glucose monitoring (CGM) be recommended in type 2 diabetics?
Patients on basal insulin or with hypoglycemia unawareness
Hep C screening age range
18-79
USPSTF 2020 guidelines recommend universal one time screen Hep C for adults ages 18-79This syndrome is characterized by weakness, unintentional weight loss, slowness, and exhaustion.
Frailty
A 48-yr-old with iron-deficiency anemia — which cancer screening must you consider regardless of age?
Always evaluate for GI malignancy (colorectal cancer is a key concern) — if iron deficiency anemia, pursue colon evaluation regardless of average-screening age; tie to CRC guidelines for workup urgency.
Which class of antihypertensives is preferred for a Black patient with hypertension and no comorbidities?
thiazide diuretics or calcium blockers
What is the next step if a diabetic patient has a consistently low GFR < 30 and is on metformin?
Discontinue metformin
HIV screening recs
15-65
According to USPSTF 2019 guidelines recommend screening for HIV ages 15-65
In older adults with advanced CKD, what is the evidence-based best approach to blood pressure targets?
individualized targets balancing risks & benefits, often relaxed in frail patients
A 79-yr-old ambulatory patient — how to reconcile CRC screening per USPSTF vs ACS (what factors do you use to individualize)?
USPSTF: routine screening stops at 75; 76–85 individualize based on health & prior screening.
ACS may be more permissive through 85 in healthy patients. Use life expectancy, prior screening history, and comorbidity to individualize.
ACC/AHA or USPSTF — at what 10-yr ASCVD risk threshold does the USPSTF recommend initiating a statin for primary prevention?
USPSTF 2022: recommend a statin for primary prevention when 10-yr CVD risk ≥10% (Grade B); selectively offer for 7.5–<10% (Grade C).
This diabetes medication should be avoided in patients with a personal or family history of medullary thyroid cancer.
GLP-1 receptor agonists
This adult vaccine must be re-adminstered every 5 years in asplenic patients.
MenACWY (meningococccal conjugate) vaccine
78 year old with CKD Stage IV, T-score -2.6, what medication to avoid?
Bisphosphonates
USPSTF vs ACS — what’s the main practical difference for lung cancer screening criteria?
USPSTF (2021): annual LDCT for adults 50–80 with ≥20 pack-year who currently smoke or quit within 15 years.
ACS updated guidance broadened eligibility with ages 50-80 who smoke or formerly smoked AND have a 20 pack-year or greater; Years since quitting NO LONGER REQUIRED.
For a patient with very high risk ASCVD on maximally tolerated statin, what LDL threshold / next agent does ACC/AHA suggest?
ACC/AHA: in very high-risk ASCVD, if LDL remains ≥70 mg/dL on maximally tolerated statin, add ezetimibe and consider PCSK9 inhibitor if LDL remains high despite ezetimibe.
At what eGFR does ADA/KDIGO say SGLT2 inhibitors can still be used/continued?
General practical rule from ADA/KDIGO: SGLT2 inhibitors can be continued at lower eGFRs for renal/CV benefit even when glycemic effects wane; many agents are allowed down to eGFR ~20–30 ml/min/1.73m² (agent-specific).
Name 3 vaccines that are routinely recommended for adults with HIV, regardless of CD4 count (assuming no prior immunity).
Hepatitis A, Hepatitis B, and Meningococcal ACWY
Which tool is validated to screen for malnutrition in hospitalized older adults?
Mini Nutritional Assessment (MNA)
Widely used for malnutrition screening in elderly patients