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Zorluk: OrtaClinical Preventive Services and Screening

A 53-year-old woman comes to the physician for a routine health maintenance visit. She has a history of hypertension that is well-controlled with hydrochlorothiazide. She does not smoke tobacco or use illicit drugs, and she drinks alcohol occasionally. She went through menopause at age 51 and has not had any vaginal bleeding or spotting since. Her body mass index is 24 kg/m², and her blood pressure is 122/76 mmHg.

A review of her medical records reveals the following:
- Mammogram 1 year ago: normal
- Colonoscopy 3 years ago (at age 50): normal
- Cervical cytology and human papillomavirus (HPV) co-testing 3 years ago: normal
- Fasting blood glucose 6 months ago: 88 mg/dL
- Lipid panel 1 year ago: normal
- HIV antibody test 5 years ago: negative
- Patient Health Questionnaire-2 (PHQ-2) today: negative

She received a Tdap booster 3 years ago. She has never been tested for hepatitis C.

Which of the following is the most appropriate next step in the preventive care of this patient?

  1. A
    Dual-energy x-ray absorptiometry
  2. B
    Fecal immunochemical testing
  3. Hepatitis C virus antibody testingCevap
  4. D
    Endometrial biopsy
  5. E
    Repeat cervical cytology and human papillomavirus co-testing

Cevap

Hepatitis C virus antibody testing
Hepatitis C virus (HCV) antibody testing is recommended as a one-time routine screening for all adults aged 18 to 79 years. Because this patient has never had this screening, offering it is the most appropriate next step in her preventive care.

Adım Adım Çözüm

1
Evaluate the patient's age and demographic risk profile.
The patient is a 53-year-old female with an average-risk profile and no high-risk behaviors or symptoms.
Patient age and specific risk factors determine the appropriate baseline screening requirements according to USPSTF guidelines.
2
Review the patient's prior screening history to identify current gaps.
Recent mammogram, colonoscopy, Pap/HPV co-test, and HIV test are all up to date. She has never had HCV screening.
Careful chart review prevents redundant testing and identifies missing critical interventions.
3
Apply current USPSTF screening guidelines to the identified gaps.
One-time HCV screening is recommended for all adults aged 18 to 79. The patient qualifies for this test today.
To select the most appropriate next step in preventive care for this specific patient visit.

Anahtar Kavram

The USPSTF recommends one-time screening for hepatitis C virus (HCV) infection in all asymptomatic adults aged 18 to 79 years, regardless of risk factors.
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Konular

Clinical Preventive Services and Screening

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