Why don't we screen all men for GC/CT?
No significant morbidity or mortality; more often symptomatic than females
Who should be screened for AAA?
B - Male smokers (at least 100 cigs/lifetime) age 65-75
(C - male nonsmokers 65-75)
A - Good evidence intervention is of benefit
B - Fair evdience
C - only for select patients, net benefit small
D - DONT recomment
I - insufficient evidence to recommend for or against
Which healthy adults should be screened for thyroid disease?
Pregnant patients
How soon does the fourth generation HIV test become positive after infection?
About 3 weeks (p24 antigen)
Name 5 options for screening for colon cancer
Cologuard q -35 years
Colonoscopy q 10
Flex SIG q5+ FOBT qyear
Virtual Colonoscopy/CT
What is the USPSTF recommendation for screening for herpes?
D - don't screen
Why??
Why don't we do routine PSAs for prostate cancer screening?
Poor specificity
Tx often worse than the disease
Die "with" prostate ca rather than "of"
Leads to unnecessary testing
Why is Shingrix covered at the pharmacy but not the office?
It is covered by Pharmacy or "D" plans, not Medicare A/B medical plans
Who should be screened for Diabetes?
Age 35-70 with BMI >25
What 3 preventive interventions should you consider in smokers?
Lung Ca screening in those 50-80
AAA screening in men 65+
Prevnar 20 -age 19
What patients need continued cervical screening after age 65 per USPSTF?
Those with CIN 2 or higher within 20 years (25 per ACS)
Those without adequate prior screening (2 neg co-tests within 10 years, one of which within 5 years OR 3 neg cytology results within 10 years)
Consider in HIV+ patients
Which test do you order if a patient has proof of a hep B vaccine and you want to know if they
1) have active Hep B
2) have ever had Hep B
What are
1) Hep B surface Antigen and
2) Hep B Core Antibody
If a patient has a normal CT for lung cancer screening, when should this be repeated?
1 year
Name 7 indications for Prevnar 20 in adults before age 65
Smoking, alcoholism
DM
Asplenia
Cardiac disease - CHF, cardiomyopathy
Liver disease
Lung disease - asthma, COPD
Immunodeficiency, generalized malignancy, HIV
Severe CKD, nephrotic syndrome,
Sickle cell
Organ transplant
Cochlear implants
How do screening guidelines change for patients who are BRCA positive?
Start mammo age 30
MRI screening yearly starting age 25-30
Consider TV US and CA-125
What vaccines does Medicare B cover?
Covid
Hep B
Tdap for Injury
Pneumococcal
What FRAX score warrants screening with a DEXA?
What is ~8% - equivalent to a 65 year old Caucasian female's risk
What are the latest guidelnes regarding Hepatitis B prevention in the US?
Screen all adults and teens "at high risk"
Vaccinate all adults age 15-59 (over 60 with RF)
Do screening guidelines differ in patients with Down syndrome? If so, what?
Hearing and vision screen every other year
TSH yearly
Cardiac and neuro exam yearly
[Consider testicular exam]