Match each patient's clinical presentation with the most appropriate next step in preventive care according to current guidelines.
- A 71-year-old man who reports a history of smoking 3 to 4 cigarettes daily for about three years in his early twenties, but has abstained since. He takes amlodipine for well-controlled hypertension.One-time screening for abdominal aortic aneurysm with ultrasonography
- A 35-year-old woman who feels well and has no breast masses. Her mother was diagnosed with breast cancer at age 46, and her maternal aunt had ovarian cancer at age 52.Administration of a familial risk assessment tool and referral for genetic counseling
- A 69-year-old man with type 2 diabetes mellitus who received a single dose of the 15-valent pneumococcal conjugate vaccine (PCV15) exactly 12 months ago.Administration of the 23-valent pneumococcal polysaccharide vaccine (PPSV23)
- A 22-year-old man who has sex with men, reports inconsistent condom use with multiple recent partners, and had a negative fourth-generation HIV test last week.Initiation of daily oral pre-exposure prophylaxis (PrEP) with antiretroviral therapy
Answer
The 71-year-old former light smoker matches with one-time abdominal aortic aneurysm screening; the 35-year-old woman with a strong family history matches with genetic counseling; the 69-year-old man who received PCV15 last year matches with PPSV23 administration; and the 22-year-old man with high-risk sexual behavior matches with HIV pre-exposure prophylaxis.
Each pairing directly applies current USPSTF and ACIP guidelines by correctly identifying the subtle triggers for screening or prophylaxis. The 71-year-old man meets the >100 lifetime cigarettes threshold for AAA screening. The 35-year-old woman's pedigree triggers BRCA risk assessment. The 69-year-old man completes his pneumococcal series with PPSV23 exactly one year after PCV15. The 22-year-old man's high-risk behavior combined with a negative HIV test warrants PrEP.
Step-by-Step Solution
Key Concept
Age- and risk-appropriate preventive care interventions require careful application of specific numeric thresholds (e.g., >100 lifetime cigarettes for AAA screening) and sequential timelines (e.g., PCV15 followed by PPSV23 at 1 year).
Estimated Time:1m 30s