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Soru

Zorluk: OrtaPreventive Care and Screening

A 4848-year-old woman comes to the clinic for a routine health maintenance examination. She feels well and has no specific complaints. Her past medical history is significant for a total abdominal hysterectomy for symptomatic benign uterine fibroids 44 years ago. She does not use tobacco, alcohol, or illicit drugs. Her family history is unremarkable. Her blood pressure is 118/76118/76 mm Hg, pulse is 7272/min, and BMI is 2424 kg/m 2^2. Her last screening mammogram was performed 1111 months ago and was normal. She has never undergone screening for colorectal cancer. Which of the following is the most appropriate next step in the preventive care of this patient?

  1. Referral for screening colonoscopyCevap
  2. B
    Cervical cytology
  3. C
    Screening mammography
  4. D
    Dual-energy x-ray absorptiometry
  5. E
    Low-dose computed tomography of the chest

Cevap

Referral for screening colonoscopy is the most appropriate next step, as average-risk adults should begin colorectal cancer screening at age 45.
The correct answer is referral for screening colonoscopy. According to the United States Preventive Services Task Force (USPSTF), screening for colorectal cancer is recommended for all average-risk adults starting at age 45 and continuing until age 75. Because this patient is 48 years old and has never undergone screening, initiating colorectal cancer screening (via colonoscopy, fecal immunochemical testing, or another recommended modality) is the single most appropriate next step in her preventive care.

Adım Adım Çözüm

1
Identify the patient's demographic risk profile and surgical history.
The patient is a 48-year-old female with no history of tobacco use and a past surgical history of a total hysterectomy for benign disease.
Age, sex, surgical history, and social habits dictate the indications for specific preventive screening tests.
2
Evaluate the patient's existing screening records against current guidelines.
She had a normal mammogram 11 months ago (due every 2 years). She had a total hysterectomy for benign fibroids (cervical cancer screening is no longer indicated).
To rule out interventions that are either premature or permanently contraindicated based on her medical history.
3
Identify missing age-appropriate screening interventions.
The patient has never been screened for colorectal cancer, which is universally recommended starting at age 45.
To select the single most appropriate and currently indicated preventive care step.

Anahtar Kavram

Average-risk colorectal cancer screening guidelines and indications for discontinuing cervical cancer screening.
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Konular

Preventive Care and Screening

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