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USPSTF
ADA
IDSA
ACC/AHA
Mixed
100
What is the recommendation for osteoporosis screening?
Screening in women age 65 years and older and in younger women whose fracture risk is equal to or greater than that of a 65-year old white woman who has no additional risk factors.
100
What are the criteria for diagnosis of diabetes?
1. A1C ≥ 6.5% OR 2. FPG ≥ 126 mg/dL OR 3. 2-h PG ≥ 200 mg/dL OR 4. Classic symptoms of hyperglycemia or hyperglycemic crisis, a random PG ≥ 200 mg/dL
100
What is the recommended treatment for CAP in a previously healthy patient with no risk factors for drug-resistant S. pneumoniae infection?
1. A macrolide (azithromycin, clarithromycin, or erythromycin) - strong recommendation 2. Doxycycline - weak recommendation
100
Name an indication for statin therapy.
1. Clinical ASCVD 2. LDL ≥ 190 mg/dL 3. Diabetes (LDL 70-189, age 40-75 y) 4. 10-year ASCVD risk ≥ 7.5% (LDL 70-189, age 40-75 y) Moderate evidence supports the use of statins if 10-year ASCVD risk 5% to <7.5 % (LDL 70-189, 40-75 y)
100
What is the recommendation per the USPSTF regarding colorectal cancer screening?
Screening in adults beginning at age 50 years and continuing until age 75 years with FOBT, sigmoidoscopy, or colonoscopy. The USPSTF recommends against routing screening for colorectal cancer in adults 76-85 yrs of age. There may be considerations that support colorectal cancer screening in an individual patient. (Grade C) The USPSTF recommends against screening for colorectal cancer in adults older than age 85 yrs. (Grade D)
200
What is the recommended screening for chlamydia and gonorrhea?
Chlamydia and gonorrhea screening in sexually active women age 24 years or younger and in older women who are at increased risk for infection.
200
What are the glycemic targets for nonpregnant adults with diabetes?
1. A1C < 7.0% 2. Preprandial capillary plasma glucose 80-130 mg/dL 3. Peak postprandial capillary plasma glucose < 180 mg/dL (postprandial glucose 1-2 h after the beginning of the meal)
200
When is it recommended to treat asymptomatic bacteriuria?
1. Pregnant women 2. Before transurethral resection of the prostate 3. Before other urologic procedures for which mucosal bleeding is anticipated. Screening for and treatment of asymptomatic bacteriuria is NOT recommended for the following persons: 1. Premenopausal, non pregnant women 2. Diabetic women 3. Older persons living in the community 4. Elderly, institutionalized subjects 5. Persons with spinal cord injury 6. Catheterized patients while the catheter remains in situ
200
What two classes of medications are recommended in all patients with a reduced EF?
ACE inhibitors and beta blockers. 2013 ACCF/AHA Guideline for the Management of Heart Failure
200
Per JNC 8, when is a blood pressure goal of <150/90 recommended?
In the general population aged ≥60 years. In the general population aged ≥60 years, if pharmacologic treatment for high BP results in lower achieved SBP (e.g., <140 mmHg) and if treatment is well tolerated and without adverse effects on health or quality of life, treatment does not need to be adjusted.
300
What is the recommendation for HIV screening?
1. Pregnant women 2. Patients ages 15-65 years. Younger adolescents and older adults who are at increased risk should also be screened.
300
What is the blood pressure goal for patients with diabetes?
Systolic blood pressure < 140 mmHg Diastolic blood pressure < 90 mmHg
300
Should empiric antimicrobial therapy for acute bacterial rhinosinusitis (ABRS) be administered for 5-7 days vs 10-14 days?
The recommended duration of therapy for uncomplicated ABRS in adults is 5-7 days. In children with ABRS, the longer treatment duration of 10-14 days is still recommended.
300
Are statins recommended for patients with heart failure?
No. "Statins are not beneficial as adjunctive therapy when prescribed solely for the diagnosis of HF in the absence of other indications for their use." Level of evidence: A. 2013 ACCF/AHA Guideline for the Management of Heart Failure
300
Per CHEST guidelines how long should parenteral anticoagulation be continued when starting warfarin to treat DVT or PE?
For a minimum of 5 days and until the INR is 2.0 or above for at least 24 hours. American College of Chest Physicians, Antithrombotic Guidelines, 9th Ed.
400
What is the recommended screening for hepatitis C?
One-time screening in adults born between 1945 and 1965, and in persons at high risk for infection.
400
What vaccinations are recommended for patients with diabetes?
1. Annual influenza vaccination (≥6 months of age) 2. PPSV23 (≥2 years of age) 3. PCV13 (≥65 years of age) 4. Hepatitis B (19-59 years of age & consider if ≥60 y/o)
400
What are the recommended first line agents for acute uncomplicated cystitis?
1. Nitrofurantoin monohydrate/macrocrystals 100 mg BID x 5 days OR 2. Trimethoprim-sulfamethoxazole 160-800 (DS) BID x 3 days (if local resistance rates do not exceed 20%) OR 3. Fosfomycin trometamol (3 g in a single dose)
400
What intensity statin is recommended for patients with diabetes?
1. Moderate-intensity statin therapy should be initiated for adults 40-75 years of age with diabetes mellitus. 2. High-intensity statin therapy is reasonable for adults 40-75 years of age with diabetes mellitus with a ≥ 7.5% estimated 10-year ASCVD risk unless contraindicated. 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults.
400
Per the CDC and WHO what is the recommendation regarding need for back-up contraception when initiating combined hormonal contraceptives?
1. If started within the first 5 days since menstrual bleeding started, no additional contraceptive protection is needed. 2. If started > 5 days since menstrual bleeding started, the woman needs to abstain from sexual intercourse or use additional contraceptive protection for the next 7 days.
500
What is the recommendation for lung cancer screening?
Annual screening with low-dose CT in adults ages 55 to 80 years who have a 30 pack-year smoking history and currently smoke or have quit within the past 15 years.
500
When are ACE inhibitors or ARBs recommended/suggested in diabetes? What needs to be monitored if these are used?
1. Hypertension (BP ≥ 140/90) OR 2. Albuminuria (urine albumin-to-creatinine ratio ≥30mg/g) Monitor serum creatinine and potassium levels for the development of increased creatinine or changes in potassium.
500
When should empiric antimicrobial therapy be initiated in patients with signs and symptoms suggestive of acute bacterial rhinosinusitis?
Any of these 3: 1. Onset with persistent symptoms or signs compatible with acute rhinosinusitis, lasting for ≥ 10 days without any evidence of clinical improvement. 2. Onset with severe symptoms or signs of high fever (≥102F) and purulent nasal discharge or facial pain lasting for at least 3-4 consecutive days at the beginning of the illness. 3. Onset with worsening symptoms or signs characterized by the new onset of fever, headache, or increase in nasal discharge following a typical viral URI that lasted 5-6 days and were initially improving ("double sickening").
500
Which beta blockers are recommended in patients with heart failure and reduced EF?
1. Bisoprolol 2. Carvedilol 3. Metoprolol succinate (sustained-release) 2013 ACCF/AHA Guideline for the Management of Heart Failure
500
Per the National Osteoporosis Foundation, when should treatment for osteoporosis be considered?
1. A hip or vertebral fracture 2. T-score ≤ -2.5 at the femoral neck, total hip or lumbar spine. 3. Osteopenia (T-score between -1.0 and -2.5 at the femoral neck or lumbar spine) and a 10-year probability of a hip fracture ≥3% or a 10-year probability of a major osteoporosis-related fracture ≥20% based on the US-adapted WHO algorithm (FRAX).