For each patient presenting to the ambulatory primary care clinic for a health maintenance examination, select the most appropriate guideline-concordant preventive screening or intervention.
- A 21-year-old asymptomatic woman who is sexually active with a new male partner.Annual nucleic acid amplification testing (NAAT) for Chlamydia trachomatis and Neisseria gonorrhoeae.
- A 38-year-old asymptomatic woman whose mother was diagnosed with advanced colorectal cancer at age 48.Initiation of screening colonoscopy, followed by repeat surveillance every 5 years.
- A 68-year-old man with a history of hypertension, active smoking, and an estimated 10-year ASCVD risk of 14%.Initiation of moderate-intensity statin therapy for primary cardiovascular prevention.
- A 28-year-old healthy man who reports having unprotected insertive and receptive anal intercourse with multiple male partners.Routine serologic testing for HIV and syphilis, alongside extragenital screening for gonorrhea and chlamydia.
Answer
The clinical scenarios correctly match with their specific preventive interventions based on USPSTF and specialty society guidelines regarding patient age, family history, and sexual risk factors.
Each match accurately reflects current evidence-based guidelines. The 21-year-old woman falls into the <25 sexually active cohort requiring annual CT/GC screening. The 38-year-old woman meets criteria for early colorectal screening due to a first-degree relative diagnosed at 48. The 68-year-old man meets ASCVD threshold (>10%) and age criteria for statin initiation. The 28-year-old MSM requires comprehensive, multi-site STI testing due to high-risk exposures.
Step-by-Step Solution
Key Concept
Application of tailored preventive care and screening guidelines based on age, sex, family history, and specific clinical risk factors.