Examkin

Question

Difficulty: MediumPreventive Care and Screening

Match each patient's clinical profile with the most strongly indicated, priority preventive screening intervention based on current national guidelines. Assume all patients are up-to-date on other routine care.

  • A 68-year-old male with a 5 pack-year smoking history in his twenties, presenting for a wellness visit with no prior cardiovascular screening.One-time abdominal duplex ultrasonography
  • A 52-year-old male with a 25 pack-year smoking history who successfully quit 12 years ago, presenting for an annual physical.Annual low-dose computed tomography (LDCT) of the chest
  • A 42-year-old asymptomatic female whose mother was diagnosed with breast cancer at age 65, presenting for routine care.Screening mammography
  • A 25-year-old asymptomatic male who has sex with men, reporting multiple partners, presenting for health maintenance.Annual serologic and nucleic acid amplification testing for sexually transmitted infections

Answer

The 68-year-old male requires one-time abdominal duplex ultrasonography; the 52-year-old former smoker requires annual low-dose computed tomography; the 42-year-old female requires screening mammography; and the 25-year-old male requires annual STI screening.
Each matched intervention corresponds precisely to current evidence-based thresholds. The 68-year-old meets the age and 'ever-smoker' criteria for an AAA ultrasound. The 52-year-old meets the age, pack-year burden, and timeline criteria for lung cancer LDCT. The 42-year-old meets the updated age criterion for initiating routine mammography. The 25-year-old meets the behavioral risk profile for annual STI screening.

Step-by-Step Solution

1
Evaluate the 68-year-old male's screening requirements.
Identify the need for abdominal aortic aneurysm screening.
He falls into the 65-75 age range and meets the criterion of having 'ever smoked' (at least 100 cigarettes lifetime), warranting a one-time ultrasound.
2
Assess the 52-year-old male's lung cancer risk.
Identify the indication for low-dose computed tomography (LDCT).
He is between 50 and 80 years old, has a smoking history of 20 pack-years or more, and quit less than 15 years ago.
3
Determine the 42-year-old female's breast cancer screening timeline.
Indicate standard screening mammography.
Her family history of breast cancer at age 65 does not require high-risk early screening, but updated population guidelines stipulate routine screening should begin at age 40.
4
Review the 25-year-old male's demographic risks.
Indicate comprehensive STI screening.
Guidelines for men who have sex with men emphasize the necessity of at least annual testing for HIV, syphilis, gonorrhea, and chlamydia.

Key Concept

Age- and risk-stratified application of major USPSTF and CDC preventive screening guidelines.
Rate this question

Topics

Preventive Care and Screening

More questions from this topic