Match each of the following ambulatory patient profiles with the single most appropriate guideline-concordant preventive care intervention. Each patient is asymptomatic, has no acute complaints, and has a normal physical examination today.
- A 41-year-old woman, BMI 23 kg/m², never-smoker. Her last cervical cancer screening with primary HPV testing was at age 38 and was negative.Biennial screening mammography
- A 58-year-old man, BMI 26 kg/m², who currently smokes 1 pack of cigarettes daily and has done so for the last 25 years. He had a normal screening colonoscopy at age 52.Annual low-dose computed tomography (LDCT) of the chest
- A 23-year-old woman, BMI 24 kg/m², non-smoker. She is sexually active with a new male partner. Her last cervical cytology was normal at age 21.Nucleic acid amplification testing for Chlamydia trachomatis and Neisseria gonorrhoeae
- A 66-year-old man, BMI 25 kg/m². He smoked a half-pack of cigarettes daily for 10 years but quit at age 30. He had a normal screening colonoscopy at age 64.One-time screening duplex ultrasonography of the abdomen
Answer
The 41-year-old woman requires screening mammography; the 58-year-old man requires LDCT of the chest; the 23-year-old woman requires chlamydia and gonorrhea screening; and the 66-year-old man requires an abdominal ultrasound for AAA screening.
Each patient requires a specific preventive intervention based on current USPSTF guidelines. The 41-year-old woman needs a mammogram (recommended starting at age 40). The 58-year-old smoker meets all criteria for LDCT (age 50-80, 20+ pack-years). The 23-year-old woman needs STI screening (sexually active, age <25). The 66-year-old former smoker needs an abdominal ultrasound for AAA (men 65-75, any smoking history >100 cigarettes).
Step-by-Step Solution
Key Concept
Application of USPSTF preventive care guidelines tailored to age, biological sex, and specific clinical risk factors.