Match each ambulatory patient's clinical risk profile with the most appropriate next step in preventive care and screening based on current guidelines.
- A 38-year-old woman who received mantle field radiation therapy for Hodgkin lymphoma at age 22.Annual screening mammography and annual breast magnetic resonance imaging (MRI).
- A 45-year-old man whose father was diagnosed with colon cancer at age 54. His last colonoscopy at age 40 was normal.Screening colonoscopy now, with subsequent screening every 5 years.
- A 52-year-old woman with a 25-pack-year smoking history who quit smoking 12 years ago.Annual low-dose computed tomography (LDCT) of the chest.
- A 60-year-old postmenopausal woman with rheumatoid arthritis on chronic systemic corticosteroids.Bone mineral density assessment with dual-energy x-ray absorptiometry (DEXA) now.
Answer
The correct pairings align each high-risk patient profile with their guideline-indicated specific screening modality and interval.
Each patient presents with a specific risk-enhancing factor that modifies average-risk screening guidelines. The 38-year-old woman requires both MRI and mammography due to prior chest radiation. The 45-year-old man needs a 5-year interval colonoscopy due to his father's early diagnosis. The 52-year-old woman meets the updated LDCT criteria (age 50 or older, 20 or more pack-years, quit less than 15 years ago). The 60-year-old woman needs a DEXA scan before age 65 due to her high-risk medication and comorbidity profile.
Step-by-Step Solution
Key Concept
Application of modified preventive screening guidelines for high-risk patient populations.