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USPSTF Guidelines

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Breast exam/mammo: ACS vs USPSTF   ACS: all women of average risk: mammogram q yr from 40 yo; USPSTF mammo q 2 yrs from 50 yo  
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USPSTF prostate cancer screening   M <75: Insufficient evidence for/against. M>75: do not screen  
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USPSTF for AAA: repair what in who?   large AAA (> 5.5 cm) in M 65-75 w/ Hx of SMK; No gdln for men 65-75 no hx SMK; gdln against screen in women  
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USPSTF AAA Screening   All M 60-75 - onetime US screening. All F 60-85 w/ 1 or more CVD risk factor; M&F > 50 w/ FH AAA  
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DM: screening:   annual: retinopathy (dilated eye exam); urine albumin; SCr  
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Diabetes Screening: USPSTF Guidelines (2008)   No need to screen asymptomatic adults with BP ≤135/80; Should screen adults with HTN (sustained BP >135/80)  
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Thyroid screening   USPSTF: no recs; ATA: TSH screen start at 35 yo & q5 yrs (sooner if risk factors or sx)  
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Lipid screen for pts w/o CVD hx:   M annual at 35 yo; F annual at 45 yo  
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USPSTF: testicular cancer   against routine screening in Asx men  
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USPSTF: Mammography   Q1-2 years >40. Baseline at 50 yo, then biennial until 74 yo.  
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BSE recommendations   ACS: BSE is an option starting in pts' 20s. USPSTF: Grade D (no benefit)  
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Women at high risk for BrCa (greater than 20% lifetime risk) should get:   an MRI and a mammogram every year  
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Who should be tested for chlamydia   Women<26 yo annually, new sex partner in past 60 days, >2 sex partners in past year, exam findings of cervical mucopus/friability/ectopy  
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Colorectal ca (CRC) screening guidelines   Screen all pts >50 yo. Colonoscopy Q 10 yrs. FOBT + sig Q5 years. ACBE + sig Q 5 yrs  
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HIV CD4 monitoring   if CD4 >350, monitor q6 months; q3 months if otherwise or w/change in clinical status  
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needlestick from HIV pt: f/u   infxn risk = 0.3%; HCW & pt s/b tested at 6 wk, 3 mos, 6 mos  
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Cervical cancer screening   paps & no hx of CIN 2 or 3; or if combined with HPV testing. Stop at 65-70 yo if 3 neg tests & no hx for 10 yrs  
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Clinical breast exam (CBE)   At least Q3 years in pt 20-39 yo, annually after 40 yo  
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USPSTF recommendations on hormone therapy (HRT)   Recommends against routine use of combined estrogen-progesterone for prevention of chronic conditions in postmenopausal women. Recommends against routine use of unopposed estrogen in postmenopausal women who had a TAH  
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