Soru

Zorluk: OrtaClinical Preventive Services and Screening

A 23-year-old woman comes to the clinic to establish care. She recently graduated from college and reports feeling well with no current health concerns. She is sexually active with a new male partner for the past two months. She uses oral contraceptives for pregnancy prevention, and the couple does not consistently use condoms. She denies any vaginal discharge, pelvic pain, dysuria, or genital lesions. Her past medical history is unremarkable. She received all standard childhood immunizations, including the human papillomavirus (HPV) vaccine series at age 11. Her last medical visit was at age 21, at which time a cervical cytology (Pap) test was performed and reported as normal. Vital signs are within normal limits. Physical examination reveals a normal-appearing cervix with no adnexal tenderness. Which of the following screening interventions is most appropriate for this patient today?

  1. Nucleic acid amplification testing for Chlamydia trachomatis and Neisseria gonorrhoeaeCevap
  2. B
    Cervical cytology
  3. C
    Primary human papillomavirus (HPV) DNA testing
  4. D
    Type-specific serologic testing for herpes simplex virus
  5. E
    Transvaginal ultrasound for ovarian cancer screening

Cevap

Nucleic acid amplification testing for Chlamydia trachomatis and Neisseria gonorrhoeae
The correct answer identifies the need for routine sexually transmitted infection (STI) screening. The United States Preventive Services Task Force (USPSTF) recommends screening for Chlamydia trachomatis and Neisseria gonorrhoeae in all sexually active women aged 24 years and younger. Nucleic acid amplification testing (NAAT) is the gold standard modality and can be performed on a vaginal swab or first-catch urine specimen. This patient is 23, sexually active, and has a new partner, making her an ideal candidate for this Grade B recommended screening.

Adım Adım Çözüm

1
Analyze the patient's demographic profile and risk factors.
The patient is a 23-year-old, sexually active female with a new sexual partner and inconsistent barrier protection use.
Age and sexual history are the primary determinants for sexually transmitted infection (STI) screening guidelines.
2
Evaluate the patient's current cervical cancer screening status.
She had a normal cervical cytology test at age 21. Current guidelines recommend screening every 3 years for women aged 21 to 29.
Since 23 - 21 = 2, she is only 2 years into her 3-year interval and does not require cervical cytology today.
3
Determine the most appropriate preventive intervention according to the United States Preventive Services Task Force (USPSTF).
Annual screening for Chlamydia and Gonorrhea is the Grade B recommendation for all sexually active women younger than 25 years.
This patient fits the exact demographic for routine STI screening via nucleic acid amplification testing (NAAT).

Anahtar Kavram

The USPSTF recommends annual screening for Chlamydia trachomatis and Neisseria gonorrhoeae in all sexually active women younger than 25 years, as well as in older women at increased risk.
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