Question

Difficulty: MediumPreventive Care and Screening

Match the following ambulatory patient profiles with their most critical, guideline-indicated preventive screening or immunization step.

  • A healthy 45-year-old male with no significant medical or family history, presenting for a wellness check after a decade without seeing a physician.Screening for colorectal cancer with colonoscopy or fecal immunochemical testing
  • A 66-year-old male with a 30 pack-year smoking history who quit 8 years ago. He recently had a normal screening colonoscopy and a normal abdominal aortic ultrasound.Annual screening with low-dose computed tomography (LDCT) of the chest
  • A 28-year-old gravida 1 para 0 at 28 weeks gestation. Her last tetanus toxoid-containing vaccine was administered 6 years ago.Administration of the tetanus, diphtheria, and acellular pertussis (Tdap) vaccine
  • A 58-year-old female with a body mass index of 33 kg/m² and normotension. She has no complaints and is up to date on her mammograms and colonoscopies.Screening for type 2 diabetes mellitus with a fasting plasma glucose or hemoglobin A1c level

Answer

The patients are successfully matched with their appropriate screening or immunization recommendations according to current age, risk factors, and USPSTF/ACIP guidelines.
Each patient requires a specific preventive intervention based on their demographic and clinical risk profile, aligning precisely with current evidence-based schedules.

Step-by-Step Solution

1
Analyze the 45-year-old male patient.
Qualifies for initiation of colorectal cancer screening.
Current guidelines lowered the screening initiation age for colorectal cancer from 50 to 45 for average-risk individuals.
2
Analyze the 66-year-old former smoker.
Qualifies for annual LDCT.
He meets the age criteria (50-80 years), pack-year criteria (≥20 pack-years), and quit-date criteria (quit <15 years ago) for lung cancer screening.
3
Analyze the pregnant woman at 28 weeks gestation.
Needs Tdap vaccination.
Tdap is recommended in every pregnancy (optimally at 27-36 weeks) to maximize maternal antibody response and passive transfer to the fetus.
4
Analyze the 58-year-old female with a BMI of 33 kg/m².
Needs diabetes screening.
Asymptomatic adults aged 35-70 with overweight or obesity require screening for abnormal blood glucose.

Key Concept

Preventive Care and Screening Guidelines (USPSTF and ACIP)
Estimated Time:1m 30s
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