Behavioral Science & Ethics USMLE Step 1 Practice Question
A 36-year-old Native American man presents for annual preventive care. He is married, works in technology, and reports excellent adherence to exercise and a balanced diet. His father died in a motor vehicle collision at age 62; his mother has hypertension and underwent coronary angioplasty at age 58. The patient denies tobacco, alcohol, and illicit drug use. Vital signs: BP 118/76 mm Hg bilaterally, HR 72/min, RR 14/min, temperature 36.8°C (98.2°F). Height 180 cm (5'11"), weight 92 kg (203 lb), BMI 28.3 kg/m². Physical examination is unremarkable. Which of the following represents the most appropriate health maintenance intervention at this visit?
Answer choices
- AReassure the patient that his normal vital signs and healthy lifestyle preclude the need for any screening testing at this time
- BInitiate discussion about diabetes screening with hemoglobin A1c or fasting glucose testingCorrect answer
- COrder coronary CT angiography given the early coronary events in his family history
- DPerform fecal occult blood testing as part of colorectal cancer screening protocol
- EScreen for depression and substance use disorder with validated questionnaires
- FRecommend 24-hour ambulatory blood pressure monitoring to assess for masked hypertension
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