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Internal Medicine

Answer 5
  1. Lipid panel. Routine screening for dyslipidemia is recommended by the USPSTF for men aged 35 years and older and women aged 45 years and older (“A” rating).8 If risk factors for coronary heart disease are present (eg, diabetes, smoking, hypertension, family history of cardiovascular disease before age 50 yr in male relatives and age 60 yr in female relatives, family history suggestive of familial hyperlipidemia), routine screening should begin at age 20 to 35 years for men and age 20 to 45 years for women. Digital rectal examination or prostate-specific antigen testing are not indicated in this case due to insufficient evidence to recommend for or against screening on a routine basis (“I” rating based on the current USPSTF recommendation).8 Based on this patient’s personal and family history, he is not at increased risk for developing colorectal cancer; therefore, screening with colonoscopy or fecal occult blood testing and flexible sigmoidoscopy would be recommended starting at age 50 years.

    8. US Preventive Services Task Force. Recommendations and rationale: screening for lipid disorders. Available at www.ahrq.gov/clinic/ajpmsuppl/lipidrr.htm. Accessed 11 Apr 2008.

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