computed tomography, discontinue screening with the patient has not smoked for 15 years. Grade B Risk Assessment Diabetes, hx of CHD, family hx of CVD, tobacco use, HTN, and obesity Age, tobacco use, years since quitting, occupational exposures, radon exposure, family hx, pulmonary fibrosis, or COPD Screening Tools Measurement of serum lipid (total cholesterol, HDL, LDL) in non- fasting and fasting samples. Abnormal screening should be repeated and averaged. Low-dose computed tomography has high sensitivity Timing Every 5 years or shorter time period for people who have higher annually
ADULT SCREENING 8 lipid levels, or longer time period for better. Levels less likely to rise after age 65. Interventions Drug therapy is often more effective then diet. Non-small cell lung cancer is treated with surgical resection when possible and with radiation and chemotherapy Benefits & Harms Benefit substantially outweigh potential harms Benefit moderately outweigh the potential harms Title Obesity in Adults Osteoporosis Population Adults age 18 and older Women age 65 or older without previous known fractures or secondary causes of osteoporosis Women younger than 65 whose 10-year fracture risk is equal to or greater than that of a 65 year old without additional risk factors Recommendation Screen for obesity. Patients with a BMI of 30 or higher should be offered or referred to intensive, multicomponent behavioral interventions Grade B Screen for osteoporosis Grade B Risk Assessment Postmenopausal women are largest risk factor. White women, and older age. Screening Tools Body mass index (BMI) or waist circumference. Current diagnostic and treatment criteria rely on dual-energy x-ray absorptiometry of the hip and lumbar spine Timing No timing interval for screening No optimal interval for repeated screening Interventions Behavioral management activities, improving diet or nutrition, increase physical activity, Adequate calcium and vitamin D intake and weight-bearing exercise, and drug therapy.
ADULT SCREENING 9 addressing barriers to change, self-monitoring, strategizing lifestyle changes. Benefits & Harms harm of screening is small Title Sexually Transmitted Infections Skin Cancer Counseling Tobacco Use in Adults Population Adults increased risk for STIs Children, adolescents, and young adults aged 10 to 24 years with fair skin Adults age 18 and older Recommendation Offer high intensity counseling Grade B Provide counseling about minimizing exposure to ultraviolet radiation to reduce risk for skin cancer Grade B Ask about tobacco use. Provide tobacco cessation interventions to those who use tobacco products Grade A Risk Assessment Current STI or have had STI within the past year, and multiple sexual partners Fair skin, eye or hair color, freckling, hx of, and sunburn Assess patients with a tobacco user identification system Screening Tools USPSTF screening tools for chlamydial, gonorrhea, herpes, hep B, hep C, HIV, and syphilis infections Low intensity counseling “5 A” Framework for counseling- Ask about tobacco use. Advise to quit
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- Fall '18
- Diabetes, asymptomatic, Adult Preventative Screening