Flashcards in Adult Health Maintenance Deck (25)
Examples of primary prevention
preventing disease before it occurs
(vaccines, education about stress management, healthy diet, exercising) removal of colon polyps to prevent colon cancer
Examples of secondary prevention
promote early DETECTION of disease
mammogram, eye exam to check for glaucoma
Examples of tertiary prevention
therapy/rehab after a disease has been diagnosed
medications for CHF, rehab programs for stroke patients, chronic pain management
Criteria for effective screening
1. Disease should have high enough prevalence
2. Time frame when person is asymptomatic and risk factors identified
3. There must be an intervention that can be given during asymptomatic period that will prevent development of disease or reduce morbidity
4. Screening test with decent specificity/sensitivity, that is cost effective and acceptable to patients
USPSTF recommendation levels
A - high certainty of benefit -> OFFER/PROVIDE service
B - high certainty of moderate benefit -> offer/provide
C - considerations for benefit to certain patients; no clear benefit or harm -> offer on individual case basis
D - not net benefit; may have significant harm -> discourage service
I - insufficient evidence for benefit -> if patient wants, make sure patient understands uncertainty about benefits vs harm
Leading cause of death in adult men
What age to screen for hypertension?
EVERYONE 18 OR OLDER (A)
When to start screening for lipid disorders (men and women)
Men 35 and over
Women 45 and over
20 years old for people with risk for CV disease
What labs can you order for lipid screening?
- nonfasting total cholesterol with HDL levels
- fasting lipid panels that include LDL
When to take aspirin to reduce risk of MI
Men aged 45-79 as long as benefit outweigh risk of GI hemorrhage (Level A)
When to ultrasound for abdominal aortic aneurysm (AAA)?
Men 65-75 who have smoked (Level B),
not really recommended for men who haven't smoked, recommended against in women who haven't smoked
In adults with low risk for coronary events, when to use ECG/stresstesting/CT for coronary calcium
not recommended in low risk adults
When to start screening for colon cancer?
50 and older (men and women, Level A)
Options for colon cancer screening (and how often)
fecal occult blood testing (FOBT) (guiac cards for 3 BMs collected at home), - annually
flexible sigmoidoscopy, - every 3-5 years
colonoscopy - every 10 years
any abnormal FOBT or flexible = colonoscopy
When to start routinely screening for prostate cancer using digital exam and/or PSA
Currently recommends against routine screening (Level D)
Who should get screened for lung cancer and with what modality?
Men and women aged 50-80 with 30 year pack history who continue to smoke or have quit less than 15 years ago should be screened with low dose CT of chest (NOT CHEST XRAY!)
Who should get screened for T2DM?
adults with HTN or hyperlipidemia
When to give Tdap booster
Any adults aged 19-65 who haven't had a Td booster in 10 years or haven't had Tdap as an adult
Who should get the influenza vaccine?
6 months and older! ANNUALLY!!!
Who should get pneumococcal polysaccharide (PPSV-23) and pneumococcal conjugate (PCV-13)?
All adults aged 65 or older or any unvaccinated adults younger than 65 who are immunocompromised or have certain chronic conditions
Who should get HepB vaccine?
those with high risk of exposure (like health care workers)
Who should get Hep A vaccine?
patients with chornic liver disease, who use clotting factors, or have occupational exposure, msm
Who should get Varicella vaccine?
no reliable history of vaccine or disease, who are seronegative on testing, who are at risk for exposure
Who should get meningococcal vaccine?
high risk groups (college dorm students, military recruits, complement deficiencies/asplenia)