A 68-year-old retired college professor presents for routine physical examination. After the patient has been reading a novel in the waiting room for ~20 minutes, the technician records his blood pressure in both arms us
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A 68-year-old retired college professor presents for routine physical examination. After the patient has been reading a novel in the waiting room for ~20 minutes, the technician records his blood pressure in both arms using an automated device. The technician notes a 20-mm Hg difference in systolic blood pressure between the right and left arms; he repeats the readings 10 minutes later and records the same asymmetrical systolic blood pressure. Which of the following is true regarding this physical finding?
a. An arm-to-arm difference of up to 20 mm Hg in systolic blood pressure is considered the upper limits of normal.
b. The difference is likely secondary to white coat hypertension and should be followed up with three subsequent monthly readings to confirm.
c. The patient should undergo ambulatory blood pressure monitoring in both arms for 24 hours to confirm conflicting measurements in the office.
d. This finding - Answer>>> d. This finding is clearly abnormal and requires immediate evaluation for possible cardiovascular emergency.
A 62-year-old manual laborer presents to an annual physical examination with concerns about skin cancer screening. He does not have any lesions of concern but was recently told by a friend that he should have his skin checked by a doctor yearly. What is the best advice for this patient according to the U.S. Preventive Services Task Force (USPSTF) recommendations on skin cancer screening from 2015?
a. The USPSTF recommends that all individual age >50 years be screened yearly for skin cancer regardless of risk factors.
b. The USPSTF recommendations mirror those of the American Cancer Society (ACS) and American Academy of Dermatologists (AAD) in recommending and annual skin cancer screening for patients age >50 years.
c. The USPSTF recommends skin cancer screening only in sun-exposed areas of fair-skinned individuals every 6 months.
d. The USPSTF recommends focused screening of individuals with a history of dysplasti - Answer>>> e. The USPSTF recommends against routine screening for skin cancer due to lack of evidence for this intervention across the general population.
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