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Flashcards in Approach to Basic Prevention Deck (42):
1

Actions aimed at eradicating, eliminating, or minimizing the impact of disease and disability

Prevention

2

The concept of prevention is best defined in the context of levels, traditionally called

Primary, secondary, and tertiary prevention

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Prevention before exposure, i.e. sanitation, nutrition, immunization,and education

Primary Prevention

4

Prevention after exposure, i.e. early detection (screening), and early intervention

Secondary prevention

5

Prevention after the disease process, i.e. reversing the course of disease, rehabilitation, and treatment

Tertiary Prevention

6

A classic example of primary prevention is

Immunizations

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New Jersey requires that children be vaccinated to attend

School or daycare

8

State vaccine requirements do allow

Religious or medical exemption

9

A general philosophical or moral objection to the vaccination is not sufficient for an exemption on

Religious grounds

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During the existence of an emergency, immunization exceptions can be suspended by the

State commissioner of Health

11

What are four routine immunizations for adults?

1.) DTap (Diptheria, Tetanus, acellular Pertussis)
2.) Polio (IPV)
3.) MMR
4.) Varicella

12

Early detection sounds good in theory, but we need to make sure that the tests are

Valid

13

What are the criteria for screening tests?

Characteristics of the:
1.) Disease
2.) Population
3.) Test

14

What is a classic example of secondary prevention?

Screening Tests

15

Significant morbidity and/or mortality, prolonged asymptomatic phase, and whether or not there are effective treatments available are all examples of characteristics of the

Disease

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The prevalence of the disease, the acceptance of screening tests, and the ability to comply/report are examples of characteristics of the

Population

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Incidence conveys information about the risk of contracting the disease, where as prevalence indicates

How widespread the disease is

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The sensitivity and specificity, the validity and reliability, and the cost effectiveness are characteristics of the

Test

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We need to make sure that our screening test fits the

Population

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The idea that if you discover a disease early in its course the patient will live longer by virtue of knowing the diagnosis, EVEN if the intervention had no effect

Lead-time bias

21

Bias in screening tests cause by the fact that slower growing tumors that are less likely to kill are more likely to be detected by one time or periodic/interval screening

Length-time bias

22

A bias in the statistics of screening tests, caused by the fact that persons who participate in screening are MORE LIKELY to engage in healthy activities, hence they are likely to live longer

Compliance/Adherence bias

23

One problem with length time bias is that slow growing cancers may never

Kill

24

What are the controversies associated with Mammography?

1.) When (age) should we start screening
2.) When (age) should we stop screening?
3.) Is it ever cost effective?

25

Reports yearly to congress about the critical evidence gaps in research related to clinical preventive services and recommends priority areas that deserve further examination

US Preventative Services Task Force (USPSTF)

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A main component of tertiary prevention is

Choosing Wisely

27

Interventions to improve health care quality and reduce harm

Choosing Wisely

28

Choosing wisely says that the measles and mumps vaccines have negligible egg protein; thus MMR can be given to

People allergic to eggs

29

Choosing wisely suggest not screening for carotid artery stenosis in

Asymptomatic adult patients

30

Says that the presence of bruit alone does not warrant serial duplex ultrasounds in low-risk, asymptomatic patients

Choose Wisely

31

Choosing wisely says that performing routine admission or preoperative chest x-rays is not recommended for

Ambulatory Patients

32

Choosing wisely says that the use of topical antibiotics on clean surgical wounds does NOT reduce the rate of infection compared to the use of

Non-antibiotic ointment or no ointment

33

Usually indicated but doesn't always save money

Primary prevention

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Screening must answer questions such as

Is the condition prevalent?
Does it have a prolonged asymptomatic phase?
Is it treatable early (i.e. does screening even matter)?

35

Pay attention to who is making the recommendations and how they came up with their

Conclusions

36

Not all tertiary interventions are

Indicated

37

Don't do a test for

"baseline" purposes

38

Prevent the disease through education and immunizations

Primary prevention

39

Screening for disease early and reducing the impact of the disease

Secondary Prevention

40

Treating the disease and supporting people with the disease

Tertiary prevention

41

Making sure not to repeat tests

Quaternary prevention

42

Broad steps to prevent disease (Not individual preventions)

Primordial prevention

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