Question

Difficulty: EasyClinical Preventive Services and Screening

Match each patient profile to the most appropriate initial screening modality indicated by current United States Preventive Services Task Force (USPSTF) guidelines.

  • A 23-year-old female university student who is sexually active and completely asymptomatic.Vaginal swab for nucleic acid amplification testing
  • A 37-year-old asymptomatic man with a body mass index of 32 kg/m².Hemoglobin A1c measurement
  • A 68-year-old man who smoked for five years in his twenties, presenting with a recent normal colonoscopy.Abdominal ultrasonography
  • A 45-year-old healthy woman with a normal body weight, presenting for her annual physical examination.Fecal immunochemical testing

Answer

The 23-year-old female matches with the vaginal swab for nucleic acid amplification testing. The 37-year-old man matches with hemoglobin A1c measurement. The 68-year-old man matches with abdominal ultrasonography. The 45-year-old woman matches with fecal immunochemical testing.
Each patient profile distinctly satisfies the criteria for a specific USPSTF Grade A or B recommendation without overlapping indications among the choices provided.

Step-by-Step Solution

1
Identify the screening needs for the 23-year-old sexually active female.
She requires sexually transmitted infection screening.
All sexually active women under 25 should be screened annually for Chlamydia and Gonorrhea using nucleic acid amplification testing.
2
Identify the screening needs for the 37-year-old man with elevated BMI.
He requires metabolic screening for diabetes.
Adults between 35 and 70 years old with overweight or obesity meet the criteria for prediabetes and type 2 diabetes screening.
3
Identify the screening needs for the 68-year-old male former smoker.
He requires evaluation of his abdominal aorta.
Men aged 65 to 75 years with any smoking history must undergo a one-time screening ultrasound for an abdominal aortic aneurysm.
4
Identify the screening needs for the average-risk 45-year-old woman.
She requires colorectal cancer screening.
The recommended age to start routine colorectal cancer screening was lowered to 45 years for average-risk individuals.

Key Concept

Appropriate application of age- and risk-based clinical preventive screening guidelines.
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