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Guidelines

USPSTF Guidelines

QuestionAnswer
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
USPSTF prostate cancer screening M <75: Insufficient evidence for/against. M>75: do not screen
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
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
DM: screening: annual: retinopathy (dilated eye exam); urine albumin; SCr
Diabetes Screening: USPSTF Guidelines (2008) No need to screen asymptomatic adults with BP ≤135/80; Should screen adults with HTN (sustained BP >135/80)
Thyroid screening USPSTF: no recs; ATA: TSH screen start at 35 yo & q5 yrs (sooner if risk factors or sx)
Lipid screen for pts w/o CVD hx: M annual at 35 yo; F annual at 45 yo
USPSTF: testicular cancer against routine screening in Asx men
USPSTF: Mammography Q1-2 years >40. Baseline at 50 yo, then biennial until 74 yo.
BSE recommendations ACS: BSE is an option starting in pts' 20s. USPSTF: Grade D (no benefit)
Women at high risk for BrCa (greater than 20% lifetime risk) should get: an MRI and a mammogram every year
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
Colorectal ca (CRC) screening guidelines Screen all pts >50 yo. Colonoscopy Q 10 yrs. FOBT + sig Q5 years. ACBE + sig Q 5 yrs
HIV CD4 monitoring if CD4 >350, monitor q6 months; q3 months if otherwise or w/change in clinical status
needlestick from HIV pt: f/u infxn risk = 0.3%; HCW & pt s/b tested at 6 wk, 3 mos, 6 mos
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
Clinical breast exam (CBE) At least Q3 years in pt 20-39 yo, annually after 40 yo
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
Created by: Abarnard