1. Letter Acronyms & Phrase Mnemonics

1. B-C-L-P (“British Columbia Lumbar Puncture”) — Cancer Staircase

Concept: Screening start ages go up by 5s in alphabetical order (40, 45, 50, 55):
- B = Breast cancer $\to$ Start age 40 (biennial mammogram to 74).
- C = Colorectal cancer $\to$ Start age 45 (Grade B: 45–49; Grade A: 50–75).
- L = Lung cancer $\to$ Start age 50 (annual LDCT to 80).
- P = Prostate cancer $\to$ Start age 55 (Grade C shared decision-making: 55–69; stops at 70).

2. DOME P-O-T-T — Cancers to NEVER Screen (Grade D)

Concept: Routine screening for average-risk asymptomatic pts is Grade D (harm/no benefit):
- P = Pancreatic cancer
- O = Ovarian cancer
- T = Testicular cancer
- T = Thyroid cancer

3. “Have Babies Safely, Check Rh Urine” — 1st Prenatal Visit Screeners

Concept: Universal baseline screening battery at the first prenatal visit (~10 wks):
- H = HIV (Grade A)
- B = Hep B (HBsAg) (Grade A)
- S = Syphilis (RPR/VDRL or treponemal) (Grade A)
- C = Hep C (anti-HCV antibody) (Grade B)
- Rh = Rh status + Rh(D) antibody screen (Grade A)
- Urine = Urine culture for asymptomatic bacteriuria (Grade B; not dipstick)

4. “The Grade B Triad in Pregnancy”

Concept: Link the letter B to pregnancy Grade B recommendations:
- Blood pressure (screen every visit; screens for preeclampsia, not dipstick protein)
- Bacteriuria (urine culture at 1st visit)
- Breastfeeding support/counseling

5. H-P-S (“Health Professional Student”) — High-Yield Newborn Screening

Concept: Three core conditions tested on state newborn heel-stick blood spots:
- H = Congenital Hypothyroidism
- P = PKU (Phenylketonuria)
- S = Sickle cell disease (hemoglobinopathy)

6. B-E-T / T-E-D — PrEP Regimens for High-Risk HIV (Grade A)

B-E-T: Bictegravir + Emtricitabine + Tenofovir
T-E-D: Tenofovir + Emtricitabine + Dolutegravir (or substitute Raltegravir for Dolutegravir)

7. A-D-T — Universal Behavioral Screeners in Adults (≥18 yo)

A = Alcohol (Audit-C or single-question screener; brief counseling if positive)
D = Drug use (Unhealthy drug screening via questionnaire, never routine UDS)
T = Tobacco (Ask, advise, provide behavioral support + FDA meds: varenicline/bupropion/NRT)

2. Numerical Hooks & Pattern Rules

1. “The 65 Hinge” (What Starts, What Stops at 65)

Starts at 65:
- DEXA scan for all women (hip & lumbar spine).
- AAA Ultrasound for men who ever smoked (one-time, age 65–75).
Stops at 65:
- Cervical cancer stops (if adequate prior negative screens in past 10 yrs).
- HIV routine screening stops (routine: 15–65).
- Anxiety screening stops (Grade B: 19–64; $\geq$ 65 is Grade I).

2. “Lady Bones, Guy Aorta”

At age 65:
- Women $\to$ Check bones (DEXA).
- Men who ever smoked $\to$ Check aorta (Abdominal ultrasound for AAA).

3. “The Number 24”

Age $\leq$ 24: Chlamydia & Gonorrhea screening for all sexually active women.
24 Weeks Gestation:
- Screen for Gestational Diabetes (GDM) (Grade B; 24–28 wks).
- Repeat Rh(D) antibody screen in unsensitized Rh(-) mothers (omitted only if biological father is confirmed Rh(-)).

4. “Jersey Numbers: 50 - 80 - 20 - 15” — Lung Cancer Screening

50 to 80: Age range eligible for annual Low-Dose CT (LDCT).
20: Pack-year smoking history minimum ( $\geq$ 20 pack-years).
15: Currently smoking or quit within the last 15 years (screening stops once quit for $> 15$ yrs or life-limiting illness develops).

5. “10 - 5 - 1” — CRC Screening Intervals

Interval matches how much/how well you see:
- 10 years: Sees everything $\to$ Colonoscopy (most sensitive).
- 5 years: Sees half or imaging-only $\to$ Flexible sigmoidoscopy (left side only) OR CT colonography.
- 1 year: Stool only $\to$ Annual FIT / FOBT (FIT-DNA/Cologuard is every 1–3 yrs).

6. “3 vs. 5” — Cervical Cancer Intervals (Ages 30–65)

Pap smear alone = Every 3 years (less sensitive $\to$ test more frequently).
Anything with HPV (hrHPV alone or Co-testing) = Every 5 years (more sensitive $\to$ can space out).

7. “Old Man, Old Smoke, One Time” — AAA Screening

Old Man: Male sex, age 65–75.
Old Smoke: Ever smoked ( $\geq$ 100 cigarettes / 5 packs in lifetime).
One Time: Single abdominal ultrasound (Grade B).

8. “Middle Age, Middle Weight” — Diabetes Screening

Age 35 to 70, overweight or obese (BMI $\geq$ 25; $\geq$ 23 in Asian Americans).
Screen with fasting glucose, A1C, or 2-hr OGTT every 3 yrs (Grade B).

9. “A sounds like 8; A before D” — Pediatric Psych Screening

Anxiety starts at age 8 (Ages 8–18: GAD-7, Grade B).
Depression starts at age 12 (Ages 12–18: PHQ-2/9, Grade B).

3. High-Yield Conceptual Decision Rules

Rule / Principle	Exam Application / Trap
”Screen Condition = YES; Screen Extreme = Grade I”	• Screen Depression (Grade B) $\to$ Screen Suicide risk in asymptomatic pts is Grade I. • Screen Adult alcohol (Grade B) $\to$ Screen Adolescent alcohol is Grade I. • Screen Adult anxiety (Grade B) $\to$ Screen Elderly ( $\geq$ 65) anxiety is Grade I.
”Grade D vs. Grade I”	• Grade D (“Don’t”): Proven no net benefit or causes net harm (e.g., PSA $\geq$ 70, Carotid US, ECG in low-risk). • Grade I (“Insufficient”): Lack of evidence/inconclusive (e.g., ABI for PAD, DEXA in men, e-cigarettes for cessation).
”Two Piles of Infections”	• Pile 1: Screen Everybody: HIV (15–65), Hep C (18–79). • Pile 2: Screen ONLY if High Risk / Pregnant: Hep B (HBsAg), Syphilis, Chlamydia/GC, Latent TB.
”10 Years Prior Rule” (CRC Family History)	If 1st-degree relative diagnosed with CRC $< 60$ yo: Start at age 40 OR 10 years before relative’s diagnosis (whichever comes first); repeat every 5 years (not 10).
Pregnancy Smoking Cessation	Behavioral interventions = Grade A. Pharmacotherapy (varenicline, bupropion, NRT) = Grade I (do not prescribe meds for tobacco cessation in pregnancy).