Examkin

Soru

Zorluk: OrtaPreventive Care and Screening

A 47-year-old man presents to the clinic to establish primary care. He has not visited a healthcare provider in over a decade and feels well, with no acute symptoms or concerns. He takes no medications. He has smoked 1 pack of cigarettes daily since age 20. He consumes 1 or 2 alcoholic beverages on the weekends. Family history is notable for a father who died of a myocardial infarction at age 75. Vital signs include a blood pressure of 126/82 mm Hg, heart rate of 74/min, and a body mass index of 27 kg/m². Physical examination is unremarkable. Which of the following is the most appropriate next step in screening for this patient?

  1. Fecal immunochemical testingCevap
  2. B
    Low-dose computed tomography of the chest
  3. C
    Abdominal ultrasonography
  4. D
    Prostate-specific antigen testing
  5. E
    Resting electrocardiography

Cevap

Fecal immunochemical testing
The correct answer is fecal immunochemical testing. The United States Preventive Services Task Force (USPSTF) recommends colorectal cancer screening for all adults aged 45 to 75 years. Because this patient is 47 years old and has not seen a physician in ten years, he is due for baseline screening. Fecal immunochemical testing is an appropriate first-line, non-invasive screening modality.

Adım Adım Çözüm

1
Evaluate the patient's demographic profile and risk factors.
The patient is a 47-year-old man with a 27 pack-year smoking history, body mass index of 27 kg/m², and no other significant specific risk factors for early-onset diseases.
Preventive screening guidelines are heavily dependent on age, biological sex, and specific risk factors such as smoking history.
2
Determine indications for colorectal cancer screening.
Current guidelines recommend initiating colorectal cancer screening at age 45 for average-risk adults.
The patient is 47 years old and has not had any preventive care in a decade, making him due for baseline colorectal cancer screening via modalities such as fecal immunochemical testing or colonoscopy.
3
Assess whether the patient meets criteria for other specific screenings listed in the options.
He does not meet the age threshold for lung cancer screening (begins at 50), abdominal aortic aneurysm screening (begins at 65), or prostate cancer screening discussion (begins at 55).
Applying the correct age cutoffs is essential to avoid over-screening and unnecessary downstream testing.

Anahtar Kavram

Colorectal cancer screening should be initiated at age 45 for average-risk adults. Age cutoffs are strict for interventions like lung cancer and abdominal aortic aneurysm screening.
Bu soruyu puanla

Konular

Preventive Care and Screening

Bu konudan daha fazla soru