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Difficulty: MediumClinical Preventive Services and Screening

Match each patient's demographic and clinical profile with the most appropriate guideline-concordant preventive or screening intervention.

  • A 12-month-old healthy infant presenting for a routine well-child evaluation.Administration of first-dose live-attenuated vaccines, such as measles, mumps, and rubella
  • A 58-year-old asymptomatic postmenopausal woman inquiring about uterine cancer screening.Reassurance and education to report any future vaginal bleeding, without diagnostic testing
  • A 42-year-old man with a body mass index (BMI) of 32 kg/m² and no other medical history.Routine screening for abnormal blood glucose and type 2 diabetes mellitus
  • A 68-year-old man who smoked approximately 150 cigarettes during college but has not smoked since.One-time screening for abdominal aortic aneurysm with ultrasonography

Answer

The 12-month-old infant receives live vaccines; the 58-year-old woman receives reassurance and education; the 42-year-old obese man is screened for diabetes; and the 68-year-old former smoker undergoes AAA screening.
Each clinical scenario requires a specific intervention based on age, sex, and risk factors as defined by current USPSTF and CDC/ACIP guidelines.

Step-by-Step Solution

1
Assess the 12-month-old infant's immunization needs.
Identify that the first doses of live-attenuated vaccines are due.
Maternal antibodies wane by 12 months, making this the standard time to initiate the MMR and varicella vaccine series.
2
Evaluate the 58-year-old asymptomatic woman requesting uterine cancer screening.
Determine that routine endometrial screening is contraindicated.
There is no mortality benefit to screening asymptomatic women for endometrial cancer; diagnostic testing is reserved for symptomatic patients presenting with postmenopausal bleeding.
3
Assess the 42-year-old man with a BMI of 32 kg/m².
Select type 2 diabetes screening.
He meets the USPSTF age (35-70) and weight (BMI ≥ 25) criteria for glycemic screening.
4
Evaluate the 68-year-old man with a brief smoking history in college.
Select abdominal aortic aneurysm (AAA) screening.
Smoking 'ever' is defined as consuming 100 or more lifetime cigarettes. Since he smoked 150 cigarettes, he meets the criteria for one-time ultrasound screening for men aged 65-75.

Key Concept

Clinical Preventive Services and Screening
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Topics

Clinical Preventive Services and Screening

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