HPCC Study Guide

What grade?

• service IS recommended

• high certainty net benefit is substantial

A

What grade?

• service IS recommended

• high certainty that net benefit is moderate OR

• moderate certainty that net benefit is moderate to substantial

B

What grade?

• recommends AGAINST routinely providing the service

• moderate or high certainty that the net benefit is small

• may be considerations that support providing service in an individual patient

C

What grade?

• recommends AGAINST the service

• moderate/high certainty that the service has NO net benefit

• harm > benefits

D

What grade?

• current evidence is INSUFFICIENT to assess the balance of benefits & harms of the service

• benefit cannot be determined

I

What prevention measure prevents the onset of disease before S/S?

Primary

What prevention measure identifies and treats asymptomatic patients who have already developed RF or preclinical disease, but in whom the condition is not yet clinically apparent?

Secondary

What prevention measure treats an established disease with the goal of reducing the impact of the ongoing illness?

Tertiary

The following are examples of what type of prevention measure?

• vaccines, lifestyle mods, healthy diet, regular physical activity, environmental interventions (clean water supply, etc)

Primary

The following are examples of what type of prevention measure?

• screening tests (mammogram for BC, colonoscopy for CRC), meds to tx early stages of diseases like HTN or HLD

Secondary

The following are examples of what type of prevention measure?

• rehab programs, surgical procedures, ongoing medication regimens to manage disease like DM or CAD

Tertiary

What is the treatment for preeclampsia?

Baby aspirin (81 mg/day)

What patient population is screened for lung cancer?

Ages 50-80

20 pack year Hx or quit in last 15 years

What is the grade & recommendation for lung CA screening in high risk patients?

Grade B

Annual low dose CT

What is the grade and recommendation for PSA screening?

55-69 y/o: Grade C

≥ 70 y/o: Grade D

What is the grade and recommendation for MDD screening?

Grade B: 12-18 y/o & adults (including pregnant, postpartum, & older)

Grade I: ≤ 11 y/o

What is the grade for suicide risk assessment in all ages?

Grade I

What is the grade and recommendation for anxiety screening?

Grade B: 8-18 y/o & ≤ 64 y/o (including pregnant & postpartum)

Grade I: ≤ 7 y/o & ≥ 65 y/o

What population should be screened for type 2 DM according to AACE?

All adults ≥ 45 y/o regardless of RF

*repeat every 3 years

What ages should women be screened for cervical cancer with pap smear (Grade A)?

Ages 21-65 every 3 years

In what population is cervical cancer screening with Pap smear NOT recommended (Grade D)?

Younger than 21, older than 65, or women w/ a hysterectomy

How often should women be tested for HPV?

Ages 30-65 every 5 years

What ages are approved for HPV vaccination?

Gardasil: 9-26 y/o

Cervarix: 10-25 y/o

What is the grade for EKG guidelines?

Low risk adults: Grade D

Intermediate or high risk: Grade I

What type of interventions are recommended for tobacco cessation?

Behavioral: Grade A

Pharmacology: Grade I

What patient population should be screened for intimate partner violence?

Women of reproductive age: Grade B

Older or vulnerable adults: Grade I

What is the grade and recommended ages for colorectal cancer?

50-75 y/o: Grade A

45-49 y/o: Grade B

76-85 y/o: Grade C

How often should CRC screening be performed?

Flex sig every 5 yrs

Flex sig every 5 yrs + annual FIT

Colonoscopy every 10 yrs

What does AAFP advise on self breast exams?

Recommends against clinicians teaching women SBE as it does not improve mortality (Grade D)

What is the grade and recommendation for mammogram screenings in low risk patients?

40-74 y/o: Grade B, biennial screening

≥ 75 y/o: Grade I

Dense breasts: Grade I

What is the grade and recommendation for mammogram screenings in high risk patients?

BRCA ½ gene mutation: Grade B → risk assessment, genetic counseling & testing

No association with BRCA ½ gene mutation: Grade D → no routine risk assessment or genetic counseling / testing

What are the grades and recommendations for chlamydia and gonorrhea screening?

Sexually active women ≤ 24 y/o: Grade B

High risk women ≥ 25 y/o: Grade B

Sexually active men: Grade I

Who should be screened for syphilis?

All asymptomatic pregnant women & high risk non pregnant adolescents & adults

*Grade A

What is the first line treatment for osteoporosis?

Bisphosphonates (-drones)

Who should be screened for osteoporosis?

Women ≥ 65 or PM women < 65 w/ 1+ RF: Grade B

Men: Grade I

Who should be screened for HIV?

*Grade A

Pregnant patients, 15-65 y/os, & younger or older if high risk

What are the screening indications for Hep B?

*screen using HbsAg followed by confirmatory test

Grade A: pregnant women

Grade B: adolescents & adults at inc risk

Who should be screened for Hep C?

*screen using anti-HCV antibody followed by confirmatory PCR

Adults aged 18-79, younger or older if high risk

*Grade A

What is the grade for latent TB screening in asymptomatic adults at an increased risk of infection??

Grade B

Target BP for HTN treatment

130/80

What populations should be screened for obesity?

*Grade B

Children & adolescents ≥ 6 y/o w/ BMI ≥ 95th percentile

Adults w/ BMI ≥ 30

What is the grade for testicular CA screening?

Grade D

What is the grade for skin CA screening w/ FBSE in asymptomatic adolescents and adults?

Grade I

What are the grades and recommendations for asymptomatic bacteriuria?

Grade B: pregnant pt → screen w/ urine culture

Grade D: non pregnant adults

What is the grade and recommendation for neural tube disorder prevention?

Grade A: persons who plan to or could become pregnant → 0.4-0.8 mg folic acid daily

Wheat ages are children screened for Autism?

*Grade I

18-30 mo

What are 2 fall prevention methods for the elderly, what grade are they?

Exercise: Grade B

Multifactorial: Grade C

What are the grades and recommendations for AAA screening?

Grade B: men 65-75 who have smoked → 1 time US screening

Grade C: men 65-75 who have NEVER smoked

Grade D: women who have NEVER smoked

Grade I: women 65-75 who have smoked

What are the grades and recommendations for baby ASA use as primary prevention for ASCVD?

Grade C: 40-59 y/o w/ ≥ 10% 10 yr CVD risk

Grade D: ≥ 60 y/o

What are the grades and recommendations for statin use as primary prevention for ASCVD?

Grade B: 40-75 y/o w/ 1+ RF & ≥ 10% 10 yr CVD risk

Grade C: 40-75 y/o w/ 1+ RF & 7.5-10% 10 yr CVD risk

Grade I: ≥76 y/o

What is the AAP periodicity screening guideline for head circumference?

Until 24 mos

What is the AAP periodicity screening guideline for weight for length?

Until 18 mos

What is the AAP periodicity screening guideline for BMI?

Start at 24 mos

What is the AAP periodicity screening guideline for BP?

Start at 3 y/o

What is the AAP periodicity screening guideline for developmental screenings?

9, 18, & 36 mos

What is the AAP periodicity screening guideline for alcohol/drug use?

Start at 11 y/o

What is the AAP periodicity screening guideline for depression?

Start at 12 y/o

What is the AAP periodicity screening guideline for maternal depression?

Screen for first 6 mos

What is the AAP periodicity screening guideline for anemia?

Check at 4 months then 12 months on

What is the AAP periodicity screening guideline for lead?

12 & 24 mos

What is the AAP periodicity screening guideline for oral health?

Start at 6 mos

What is the AAP periodicity screening guideline for fluoride varnish?

Between 6 mos-5 yrs

What is the AAP periodicity screening guideline for dyslipidemia?

8-11 yrs & 17-21 yrs