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Difficulty: MediumClinical Preventive Services and Screening

Match each patient demographic and clinical risk factor profile to the most appropriate Grade A or B USPSTF screening recommendation.

  • A 68-year-old asymptomatic man with a 35-pack-year smoking history who quit 5 years agoAnnual screening with low-dose computed tomography (LDCT) of the chest
  • A 22-year-old asymptomatic sexually active woman with a new male partnerScreening with nucleic acid amplification testing for Chlamydia and Gonorrhea
  • A 52-year-old man with a body mass index of 32 kg/m² and blood pressure of 135/85 mm HgScreening for type 2 diabetes mellitus with fasting plasma glucose or hemoglobin A1c
  • A 66-year-old man with a history of smoking 1 pack per day for 10 years in his twenties, who has never been screened for vascular conditionsOne-time screening for abdominal aortic aneurysm with ultrasonography

Answer

Match the lung cancer screening to the 68-year-old former heavy smoker; the STI screening to the 22-year-old sexually active woman; the diabetes screening to the 52-year-old man with obesity; and the AAA screening to the 66-year-old man with a remote smoking history.
Each patient profile is correctly matched to a corresponding USPSTF Grade A or B recommendation: LDCT for adults 50-80 with a 20+ pack-year history; STI screening for sexually active women under 25; diabetes screening for overweight/obese adults 35-70; and one-time AAA screening for men 65-75 with any smoking history.

Step-by-Step Solution

1
Evaluate the 68-year-old man's risk factors.
He meets the age (50-80), pack-year (>=20), and quit duration (<15 years) criteria for lung cancer screening.
To identify the appropriate USPSTF recommendation for his specific smoking history.
2
Evaluate the 22-year-old woman's profile.
She is a sexually active woman under age 25, which warrants chlamydia and gonorrhea screening.
To apply age-based STI screening guidelines.
3
Evaluate the 52-year-old man's risk factors.
His age (35-70) and BMI (>=25) mandate screening for type 2 diabetes.
To address metabolic risk factors per USPSTF guidelines.
4
Evaluate the 66-year-old man's profile.
He is a man aged 65-75 with a history of smoking ('ever smoked' criterion met), which requires a one-time AAA screening.
To apply vascular screening guidelines for former smokers.

Key Concept

USPSTF Grade A and B recommendations are population-specific guidelines based on age, sex, and specific risk factors (e.g., smoking history, BMI, sexual activity).
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Topics

Clinical Preventive Services and Screening

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