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Ambulatory Care-Geriatrics

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Breast Cancer
Target population
ACOG: Women ≥40 USPSTF: Women between 50-75 yoBreast Cancer
Screening test
MammogramBreast Cancer
Frequency
ACOG: Every 1 year USPSTF: Every 2 yearsBreast Cancer
Cervical Cancer
Target population
Begin at 21 yo. Stop at 65 (if have had routine screening and no CIN II or worse in past 20 years).<br>Cervical Cancer
Screening test
Pap smear (+/- HPV co-testing)Cervical Cancer
Frequency
Age 21-29 – pap every 3 years Age 30-65 – pap+HPV every 5 yearsCervical Cancer
Colorectal Cancer
Target population
Men and Women between 50-75 yoColorectal Cancer
Screening test
Colonoscopy (Fecal Occult Blood Test [FOBT] and flex sig are alternatives)Colorectal Cancer
Frequency
Every 10 years (start younger if high risk; every 5 years if fam hx) - FOBT X3 yearly - Flex sig every 5 yrsColorectal Cancer
Lung Cancer
Target population
Adults 55-80 yo with >30 pack-year smoking hx (and currently smoke or have quit within the past 15 years).Lung Cancer
Screening test
Low dose CTLung Cancer
Frequency
YearlyLung Cancer
Diabetes
Target population
Adults with BP of ≥135/80, Adults with risk factors such as BMI ≥25, positive family history, high risk ethnic > Screening test Diabetes group> Frequency
Fasting plasma glucose, Hemoglobin A1C, and/or 2 hr OGTT
No official recommendation (approx. every 3 years)
Hyperlipidemia
Target population
Men ≥ 35 yo, earlier if incr risk, Women ≥ 45 yo, earlier if incr riskHyperlipidemia
Screening test
Lipid panelHyperlipidemia
Frequency
No official recommendation (consider every 5 years)Hyperlipidemia
Hypertension
Target population
All adults ≥ age 18Hypertension
Screening test
Blood pressure screeningHypertension
Frequency
No official recommendation (consider every 2 years)Hypertension
Abdominal aortic aneurysm
Target population
Men between 65-75 who have ever smokedAbdominal aortic aneurysm
Screening test
Abdominal ultrasoundAbdominal aortic aneurysm
Frequency
One timeAbdominal aortic aneurysm
Osteoporosis
Target population
Women ≥65 yo and women ≤65 at high risk (heavy ETOH use, smokers, low BMI, premature menopause – calculate risk using FRAX tool)Osteoporosis
Screening test
DEXA scanOsteoporosis
Frequency
No official recommendationOsteoporosis
Chlamydia
Target population
Sexually active women ≤24 yo and ≥25 if high riskChlamydia
Screening test
Vaginal or cervical swab (urine also acceptable)Chlamydia
Frequency
YearlyChlamydia
Hepatitis C
Target population
Adults born between 1945 and 1965, People at high risk for infection (IVDU)Hepatitis C
Screening test
Hep C AbHepatitis C
Frequency
One time for pts born 1945-1965 Regularly if ongoing riskHepatitis C
Depression
Target population
All adultsDepression
Screening test
Depression screen (PHQ 2 is an option)Depression
Frequency
No official recommendation (consider annually)Depression
Alcohol Misuse
Target population
All adultsAlcohol Misuse
Screening test
AUDITAlcohol Misuse
Frequency
No official recommendation (consider annually)Alcohol Misuse
HIV
Target population
USPSTF: adults aged 15-65 yo, also those at high risk CDC: all patientsHIV
Screening test
HIV test (rapid or routine)HIV
Frequency
One time screen in low risk patients, regularly in high riskHIV