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First AId 2CK > Preventative Medicine - MTB > Flashcards

Preventative Medicine - MTB Flashcards

1
Q

Cancer screening test that lowers the most mortality

A

Mammogram

  • mortality benefit greatest > 50 years old
  • test should be stated in all women > 50
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2
Q

Clinical breast examination

A

has no proven benefit

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3
Q

Cervical cancer screening

A

Pap smear lowers mortality

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4
Q

Pap smear

A
  • cervical cancer screening
  • should start at 21 REGARDLESS OF SEXUAL ACTIVITY ONSET
  • should be done at least every 3 years until 65
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5
Q

Colonoscopy

A
  • at age 50 years, then every 10 years
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6
Q

Cervical cancer

A
  • Pap smear at age 21, then every 2-3 years

- stop at age 65 unless no previous screening

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7
Q

HPV testing

A
  • right for ASCUS

- If ASCUS is HPV-positive, do colposcopy

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8
Q

Colon cancer screening if family member had the disease

A

Screening should begin at 40 or 10 years earlier than the family member was diagnosed, whichever is earlier

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9
Q

Hereditary nonpolyposis colon cancer syndrome (HNPCC)

A
  • aka Lynch syndrome
  • defined as colon cancer in 3 family members in 2 generations having the disease with 1 having it prematurely (before 50)
  • screening should begin at 25 and be done every 1-2 years
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10
Q

Prostate Cancer Screening

A
  • no recommendation to screen patients routinely for prostate cancer either w/ PSA or DRE
  • recommendation AGAINST men > 75 on disadvantages of treatment
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11
Q

Indications for influenza vaccination and pneumococcal pneumonia vaccination

A
  • Pts with chronic lung, heart, liver, kidney and cancer
  • HIV-positive patients
  • Patients on steroids
  • Patients with diabetes
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12
Q

Influenza vaccine is recommended yearly in general population. Has greatest benefit following persons:

A
  • Everyone > 50
  • Pregnant women
  • Health care workers
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13
Q

Pneumococcal vaccine is different from influenza vaccine in that:

A
  • Indicated for patients > 65

- Administered as single injection

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14
Q

Meningococcal vaccination

A
  • is now routine at age 11
  • children especially at high risk, who be vaccinated even early
  • are those functional or anatomic asplenia
  • those with terminal complement deficiency
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15
Q

HPV vaccination

A
  • quadrivalent vaccine that should be administered to ALL FEMALES BTWN 13 and 16
  • acceptable in boys
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16
Q

Varicella-Zoster Vaccine

A
  • against the reactivation of varicella zoster (shingles) should be performed in everyone above 60 years
  • vaccine is higher-dose form of varicella vaccine given to children
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17
Q

Smoking Cessation

A
  • should be screened for tobacco use and advised against it
  • effective method is use oral meds (BUPROPION and VARENICLINE)
  • less effective therapies are nicotine patches and gums
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18
Q

Osteoporosis

A
  • should screened with bone densitometry at age 65
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19
Q

Abdominal Aortic Aneurysm

A
  • all men about age 65 who were ever smokers should be screened once with an ultrasound
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20
Q

Diabetes Screening

A
  • routine only in those with hypertension
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21
Q

Hypertension

A
  • all patients above age 18 should have their blood pressure checked at every office visit
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22
Q

Hyperlipidemia

A
  • Men > 35 and women > 45 should be screened for hyperlipidemia
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23
Q

Mammography

A
  • should be done starting at age 40 - 50 every 2 years
  • reduction in mortality greatest above 50
  • screening can stop at age 75
24
Q

Who is most likely to benefit an asymptomatic patient with multiple first-degree relatives with breast cancer?

A

Tamoxifen or raloxifene – result in 50% to 66% reduction in breast cancer

25
Q

BRCA Testing

A
  • not necessarily beneficial screening test

- positive test means an increased risk of cancer

26
Q

Cervical Cancer Screening

A
  • Pap smear is done from 21 to 65 years (every 3 yars)
27
Q

Combined Pap and HPV testing

A
  • starts at ages 30 to 65 stretches the interval to 5 years
28
Q

Chlamydia screening

A
  • screen women 15 - 25 years old
29
Q

Capsule endoscopy

A
  • detects small bowel bleeding

- it is not a screening method

30
Q

Digital rectal exam

A
  • not proven to lower mortality in any disease

- always a wrong choice

31
Q

Lung Cancer Screening

A
  • no test to lower mortality from lung cancer

- CXR detects many lesions that can be insignificant

32
Q

Lipid Screening

A
  • recommended for all patients with diabetes, HTN, CAD, or CAD equivalents: carotid disease, peripheral vascular disease, aortic disease
33
Q

Cholesterol and LDL measurement is recommended for healthy patients when:

A
  • Men > 35

- Women > 45

34
Q

Hypetension

A
  • indicated for all patients above age 18 at every visit

- screening adults should be done every 2 years

35
Q

Diabetes Mellitus

A
  • screening for diabetes with fasting blood glucose (2 measurements > 125 mg/dL or HgA1C > 6.5%) is done when patients has:
  • hypertension, hyperlipidemia
36
Q

Two most beneficial vaccine for adults

A
  • Influenza (either inactivated or live attenuated vaccine)

- Pneumococcus

37
Q

Live attenuated vaccine

A
  • should NOT be used in patients> age 50
38
Q

Both influenxa and pneumococcal vaccine are recommended for all patients:

A
  • Chronic heart, liver, lung and kidney disease including asthma
  • HIV/AIDS
  • Steroid users
  • Immunocompromised pts such as cancer or functional or anatomic splenia
  • Diabetes mellitus
39
Q

Pneumococcal vaccine indications

A
  • everyone above age 65
  • cochlear impant
  • CSF leaks
  • Alcoholics
  • One vaccine ABOVE 65 ONLY
  • Single revaccination after 5 yrs if patient is immunocompromised or if first injection is before 65
40
Q

Influenza vaccine

A
  • everyone yearly
  • healthcare workers
  • pregnant patients
41
Q

Herpes (Varicella) Zoster Vaccine

A
  • routinely indicated in all children

- higher dose version of varicella vaccine indicated in all patients above age 60 (prevents post-herpetic neuralgia)

42
Q

Hepatitis A and B vaccines most benefit in which patients

A
  • Chronic liver disease
43
Q

Hep A and B vaccines combined indication

A
  • Chronic liver disease
  • Men who have sex with men and multiple sex partners
  • Household contacts w/ Hep A and B
  • Injection drug users
44
Q

Hep A specific indications

A
  • Travelers to countries of high endemicity
45
Q

Hep B specific indications

A
  • End stage renal disease (dialysis)
  • Healthcare workers
  • Diabetes
46
Q

Tetanus Vaccine

A
  • Td (toxoid) every 10 years
  • One Tdap (tetanus w/ acellular pertussis) as one of boosters
  • Tetanus immune globulin in those never vaccinated
47
Q

Meningococcal Vaccine

A
  • routinely indicated at age 11 visit
    Also indicated for adults w/ following circumstances
  • Asplenia
  • Terminal complement deficiency
  • Military recruits
  • Residents of college dorms
  • Travelers to Mecca or Medina in S. Arabia for Hajj (pilmrimage)
48
Q

Strongest indication for meningococcal vaccination

A

Asplenia

- presents person at high risk for disseminated meningococcal injection

49
Q

Tetanus immunization for person never vaccinated

A

Immune globulin

50
Q

Tetanus immunization in person with dirty wound

A

Booster after 5 years

51
Q

Tetanus immunization in clean wound

A

Booster after 10 years

52
Q

Osteoporosis

A
  • should be screened with bone densitometry at age 65 with DEXA scan
  • Hip fracture in elderly pt carries an extremely high risk
  • preventing fracture with bisphosphonates
53
Q

Abdominal Aortic Aneurysm

A
  • all men above age 65 w/ smoking hx should be screened at least once to exclude aneurysm
  • AAA should be repaired if it is wider than 5 cm
  • Also screen 65 - 75 w/ family hx of AAA
54
Q

Domestic Violence

A
  • all pts should be asked about possibility of intimate partner violence
  • cannot report injury w/o consent of patient
55
Q

Alcohol Dependence

A
  • self-diagnosed disease
  • ask CAGE
  • Feel need to CUT DOWN on drinking?
  • Do you get ANGRY when people ask about drinking?
  • Do they feel GUILTY about amount drinking?
  • Do you feel you need for morning EYE-OPENER?

First AId 2CK (22 decks)

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