A 68-year-old man presents to the ambulatory clinic to establish care. He recently relocated and states he has not seen a healthcare provider or had any medical screenings in over 10 years. His past medical history is significant for hypertension and hyperlipidemia. He has a 40-pack-year smoking history but successfully quit smoking 18 years ago. He currently takes amlodipine and atorvastatin. Vital signs show a blood pressure of 128/78 mmHg, heart rate of 72/min, and a BMI of 27 kg/m . Physical examination is unremarkable. Which of the following preventive interventions are indicated for this patient at today's visit? (Select all that apply)
- One-time screening for an abdominal aortic aneurysm with ultrasonographyCevap
- BAnnual screening for lung cancer with low-dose computed tomography
- Administration of the 20-valent pneumococcal conjugate vaccineCevap
- DScreening for osteoporosis with dual-energy x-ray absorptiometry
- Screening for colorectal cancer with a colonoscopyCevap
Cevap
The correctly indicated preventive interventions for this patient are one-time screening for an abdominal aortic aneurysm, administration of the 20-valent pneumococcal conjugate vaccine, and screening for colorectal cancer with a colonoscopy.
The patient meets strict criteria for three preventive interventions. First, as a man aged 65 to 75 with a history of smoking, he requires a one-time abdominal aortic aneurysm screening with ultrasonography. Second, as an adult over the age of 65, he requires pneumococcal vaccination (e.g., PCV20). Third, as an adult between the ages of 45 and 75 who has not had medical care in a decade, he requires routine colorectal cancer screening (e.g., via colonoscopy).
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Anahtar Kavram
Application of age-specific, sex-specific, and risk-factor-specific preventive care guidelines (USPSTF and ACIP) in older adults.