Evaluate the following patient profiles during routine ambulatory visits. Match each patient with the most appropriate, guideline-concordant next step in preventive care based on current United States Preventive Services Task Force (USPSTF) and Advisory Committee on Immunization Practices (ACIP) recommendations.
- A 66-year-old woman who underwent a total hysterectomy for symptomatic uterine leiomyomas five years ago and had three consecutive negative routine Pap tests prior to the surgery.Discontinue routine cervical cytology and human papillomavirus screening indefinitely.
- A 45-year-old man with no chronic medical conditions and a body mass index of 33 kg/m², presenting for his first primary care visit in five years.Order fasting plasma glucose or hemoglobin A1c testing.
- A 28-year-old woman at 30 weeks gestation in her first pregnancy, who received a tetanus-diphtheria-acellular pertussis (Tdap) booster at age 24.Administer the tetanus-diphtheria-acellular pertussis (Tdap) vaccine during this visit.
- A 38-year-old healthy woman whose mother and maternal aunt were both diagnosed with breast cancer in their early 40s.Perform a familial risk assessment tool (e.g., Ontario Family History Assessment Tool) for BRCA testing referral.
Cevap
The post-hysterectomy patient requires cessation of cervical screening. The 45-year-old man with obesity requires diabetes screening. The pregnant patient requires Tdap vaccination. The woman with a strong family history of breast cancer requires a familial risk assessment for BRCA.
Each correct match strictly follows current evidence-based guidelines for primary care. Cervical screening is stopped after benign hysterectomy. Diabetes screening starts at age 35 for overweight/obese individuals. Tdap is required in every pregnancy between 27-36 weeks. A strong family history of early breast cancer prompts BRCA risk assessment.
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Anahtar Kavram
Application of age-, sex-, and risk-specific USPSTF and ACIP guidelines for preventive screening and immunizations in adults.