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Difficulty: EasyPreventive Care and Screening

During an intake evaluation at a community health center, a 52-year-old biological male establishes primary care. The patient reports feeling entirely well and notes his last medical encounter was roughly 15 years ago for a minor musculoskeletal injury. He is a lifetime non-smoker, consumes one alcoholic beverage weekly, and has no known family history of chronic illness or malignancy. His vital signs and physical examination are within normal limits. Which of the following preventive interventions are indicated for this patient today? (Select all that apply)

  1. Screening for colorectal cancerAnswer
  2. Administration of a tetanus-containing vaccine boosterAnswer
  3. C
    Screening for lung cancer with low-dose computed tomography
  4. D
    Screening for an abdominal aortic aneurysm with ultrasonography
  5. E
    Screening for osteoporosis with dual-energy x-ray absorptiometry

Answer

The indicated preventive interventions for this patient are screening for colorectal cancer and administration of a tetanus-containing vaccine booster.
The correct interventions are colorectal cancer screening, which the USPSTF recommends for all average-risk adults aged 45 to 75, and a tetanus-containing vaccine booster (Td or Tdap), which the ACIP recommends every 10 years for adults. Because the patient has not seen a physician in 15 years, he is due for both.

Step-by-Step Solution

1
Analyze the patient's demographic and clinical profile.
The patient is a 52-year-old male, lifetime non-smoker, at average risk for chronic diseases, with no healthcare contact in the past 15 years.
Patient age, sex, smoking history, and interval since last visit dictate the indicated preventive services.
2
Evaluate indications for cancer screening based on guidelines.
Colorectal cancer screening is indicated because the patient is over age 45. Lung cancer screening is not indicated because the patient has no smoking history.
To apply current USPSTF recommendations for age-appropriate cancer prevention.
3
Evaluate indications for adult immunizations.
A tetanus-containing booster (Td or Tdap) is indicated because more than 10 years have passed since his last medical encounter.
Adult immunization schedules require a tetanus booster every 10 years to maintain immunity.
4
Evaluate indications for other vascular and metabolic screenings.
Abdominal aortic aneurysm screening is excluded due to age (<65) and non-smoking status. Osteoporosis screening is excluded as he is not a female over 65.
To rule out routine tests that are inappropriate for the patient's specific demographic.

Key Concept

Age-appropriate cancer screening and routine adult immunizations in the primary care setting.
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Topics

Preventive Care and Screening

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