Clinical Medicine Examination: USPSTF Preventive Screening Guidelines, PSA Prostate Cancer Decision-Making, BRCA Genetic Risk Assessment, Colorectal Cancer Screening Modalities, Low-Dose CT Lung Cancer Detection, Mammography Breast Cancer Screening, Cervi

Clinical Medicine Examination: USPSTF Preventive Screening Guidelines, PSA Prostate Cancer Decision-Making, BRCA Genetic Risk Assessment, Colorectal Cancer Screening Modalities, Low-Dose CT Lung Cancer Detection, Mammography Breast Cancer Screening, Cervical Cytology and HPV Testing, HIV-1 Infection Pathophysiology, CD4 Immunodeficiency Thresholds, Opportunistic Infection Prophylaxis, Disseminated Gonococcal Disease, Chlamydia Trachomatis Infection, Neisseria Gonorrhoeae Cervicitis, Treponema Pallidum Syphilis Staging, Jarisch–Herxheimer Reaction, Reactive Arthritis Syndrome, Human Papillomavirus Condyloma Acuminata, Herpes Simplex Viral Infection, Haemophilus Ducreyi Chancroid Ulcers, Lymphogranuloma Venereum Infection, Pelvic Inflammatory Disease Pathogenesis, Trichomonas Vaginalis Protozoal Infection, Candida Vulvovaginitis Mycosis, Bacterial Vaginosis Microbiome Imbalance, Beta-Lactam Antibiotic Pharmacology, Tetracycline Antimicrobial Therapy, Macrolide Drug Interactions, Fluoroquinolone Adverse Effects, Sulfonamide Exam Questions Verified and Provided with Complete A+ Graded Rationales Latest Updated 2026 USPSTF: PSA based screening for prostate cancer Men aged 55-69: the decision to undergo periodic prostate-specific antigen (PSA) based screening for prostate cancer should be an individual one Screening offers a small potential benefit but also potential harms The decision should be made by the patient and clinician based on family history, race/ethnicity, comorbid medical conditions, patient values about teh benefits/harms of screening/treatment-specific outcomes, and other health needs Clinicians should not screen men who do not express a preference for screening USPSTF recommends against PSA based screening for prostate cancer in men greater than 70 USPSTF: Genetic risk assessment and BRCA mutation testing for breast and ovarian cancer susceptibility PCP assess women with personal or family history of breast, ovarian, tubal, or peritoneal cancer or who have ancestry associated with breast cancer susceptibility 1 and 2 gene mutations with an appropriate brief familial risk assessment tool. Women with a positive result on this risk assessment tool should receive genetic counseling and, if indicated after counseling, genetic testing USPSTF: colorectal start at 45 (grade b) or 50 years (grade A) Guaiac-based fecal occult blood test (gFOBT) or fecal immunochemical test (FIT) (annually) sDNA-FIT (every 1 or 3 years) colonoscopy (every 10 years) Flexible sigmoidoscopy (every 5 years) CT colonoscopy (every 5 years) Flexible sigmoidoscopy with FIT (flexible sigmoidoscopy every 10 years plus FIT annually) Continue screening until 75. The decision to screen in adults 76 to 85 years of age should be an individual one, with consideration of the patient's overall health and prior screening history American cancer society: colorectal start at 45 Guaiac-based fecal occult blood test (gFOBT) or fecal immunochemical test (FIT) (annually) stool DNA test (every 3 years) colonoscopy (every 10 years) Flexible sigmoidoscopy (every 5 years) CT colonoscopy (every 5 years) continue regular screening through age 75 years if in good health. For people aged 76 to 85, the decision to screen should be individualized and discussed with the healthcare provider. Screening should stop in people over aged 85 years Colonoscopy should be performed if any test has a positive result. Consider earlier screening for those at increased or high risk for colorectal cancer USPSTF: lung annual low dose CT age 50 to 80 20 pack year history and currently smoke or who have quit within the past 15 years d/c if not smoked in 15 years or develops a health problem that substantially limits life expectancy or the ability or willingness to have curative lung surgery American cancer society: lung annal screening with low dose CT ages 55 to 74 30 pack year history and currently smoke or who have quit within the past 15 years screening should continue until the age of 74 years as long as patient is in good health USPSTF: breast cancer women age 40-49: decision to start individual 50-74 biennial 75 evidence is insufficient to assess the additional benefits and harms of screening American cancer society: breast cancer 40-44: consider annual mammo 45-54: annual mammogram 55 and older: annually or every 2 years continue as long as life expectancy is 10 years or longer USPSTF: cervical cancer start age 21 if age less than 30, pap q 3 years preferred age 30-65: pap q3, HPV q5 or pap/HPV co test every 5 years ACS: cervical cancer start age 25 if age less than 30, HPV q 5 years preferred age 30-65: pap q3, HPV q5 or pap/HPV co test every 5 years HIV Cause: HIV-1 most common strain in US Signs and symptoms: Hairy leukoplakia of tongue (caused by Epstein-Barr virus of the tongue), recurrent candidiasis, thrush, fever, weight loss, diarrhea, cough, sob, Kaposi's sarcoma, symptoms develop 2-4 weeks Diagnostics: ELISA -screening; Western blot - confirmatory for antibodies HIV PCR if both + ; It can take 3-12 weeks for HIV antibody test to detect HIV Treatments: Prophylaxis if CD4 200: bactrim daily; pregnancy start Zidovudine; newborns start 6-12 hours post delivery Concerns: AIDS = CD4 200; toxoplasma gondil; bactrim daily, avoid cat litter, uncooked pork/beef, bird stool, turtles, amphibians, gardening Disseminated gonococcal disease Cause: Signs and symptoms: petechial or pustular skin lesions of hands/soles; swollen, red, tender joints in one large joint (knee). may have s/s STD, pharengitis with green purulent throat exudates not responding to abx Diagnostics: Treatments: Ceftriaxone 1g IM or IV every 24 hours Concerns: Chlamydia trachomatis Cause: atypical bacteria incubation 7-14 days Signs and symptoms: Asymptomatic, most common STD in US; can occur in endometrim Diagnostics: NAAT test for pharynx/rectal; GenProb for cervix/urethra; friable cervix with yellow discharge Treatments: Doxy 100 BID 7 days; azithromycin 1G single dose; treat partners with azithro 1G once, test of cure only from preg women Concerns: Leads to PID (PID has + chandelier's test) most common 25 Neisseria gonorrhoeae Cause: Gm-diplococci bacteria incubation 1-5 days Signs and symptoms: purulent green-colored vag/penile d/c; exam shows discharge on cervix which may bleed, may be asymptomatic, cervicitis, urethritis, pharyngitis, bartholin gland abscess, salpingitis, epididymtiis/prostatitis Diagnostics: NAAT test for pharynx/rectal samples; GenProbe for cervix/urethra Treatments: Ceftriazone 500mg IM once plus doxy 100BID if chlamydia not ruled out Concerns: