Health maintenance screening may be
effectively incorporated into an inpatient admission if appropriate.
Recommendations from the US
Preventive Services Task Force, Guide to Preventive Services, 3rd
Ed. www.ahcpr.gov/clinic
- ASA: h/o CAD or risk factors for
CAD
- Lipids: lipid panel for men > 35, women > 45, or risk factors,
CAD
- Osteoporosis: screen all women > 65 or > 60 if risk factors
(low BMI, fractures, white/Asian, smoking, heavy EtOH/caffeine). Screen with DXA.
- Chlamydia: all sexually active women < 25 or older if risk
factors
- Cervical cancer: Pap smear for all sexually active women within 3
yrs of sexual debut. Repeat q3yrs unless high risk activity or HIV (then q6m to 1yr)
- Breast cancer: mammography & clinical breast exam women > 40
(q1 –2yrs)
- Prostate cancer: PSA for men 50 – 70. Start at 45 if increased risk (African
American, 1st degree family history). If PSA > 4 refer
for further evaluation.
- Colorectal cancer: patients > 50 use fecal occult blood testing
(3 consecutive samples) & flexible sigmoidoscopy
q 5-10yrs.
Follow-up all positive results with colonoscopy.
- Hormone replacement therapy: balance benefits of decreased
osteoporosis and colorectal cancer with increased coronary artery disease,
breast cancer, DVTs, CVAs,
& cholecystitis.
- Vaccinations: Influenza vaccine (q1yr) if > 65 or ill.
Pneumovax (q5yrs, q1yr if CD4 < 200) if > 65
or increased risk. Tetanus/diphtheria
(Td) q10yr (note: most infections are among patients
> 50, may need primary series if never vaccinated). HBV (0, 1, & 6
m) all young adults or high risk or co-existing liver disease (if non-immune), HAV (havrix or twinrix 0 & 6m) if co-existing liver disease.