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STEP 2 Biostats and epidemiology > Cancer/adolescent screen, prevention > Flashcards

Cancer/adolescent screen, prevention Flashcards

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1
Q

Ideal screening program. disease characteristics? 4

A

common
serious
LONG ASYMPTOMATIC PHASE
CORRECTABLE if identified early

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2
Q

Ideal screening program. patient characteristics? 2

A

HIGH PREVALENCE in screened population
Appropriate age range and gender

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3
Q

Ideal screening program. test characteristics? 3

A

LOW COST relative to disease severity

High sensitivity and specificity

ACCEPTABLE to broad range of patients

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4
Q

Ideal screening program. program characteristics? 4

A

Identifies population to be screened

Avoids ,,overdiagnosis” (detects benign/indolent disease)

Avoids ,,lead-time” bias (detects disease early but does not alter ultimate prognosis)

IMPROVES OUTCOMES of screened vs nonscreened population

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5
Q

Primary prevention prevents what?

A

prevent the onset of disease

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6
Q

Primary prevention aim?

A

Aim is to reduce exposure

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7
Q

Primary prevention examples to reduce exposure?

A

For example:
* Weight loss, smoking, alcohol, eating better.
* Vaccination.

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8
Q

Secondary prevention ,,prevents” what?

A

early detection to delay progression

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9
Q

Secondary prevention screening tests what are?

A

Screening tests with high sensitivity.

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10
Q

Secondary prevention: positive screening tests?

A

If positive –> intervene with lifestyle and medications.

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11
Q

Tertiary prevention prevents what?

A

preventing complications.

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12
Q

Tertiary prevention. ka darom sitoj prevencijoj?

A

Treatment of disease; lifestyle modifications and drugs.

More responsive than preventive.

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13
Q

Cancer screening. Colon: Age to start? 2

A

a) 50
b) 10 year before diagnosis of a parent

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14
Q

Cancer screening. Colon. How to do? 3

A

FKS every 10 year
OR
Flexible sigmoidoscopy every 5 year + FOBT every 3 years
OR
FOBT every year

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15
Q

Cancer screening. Colon. at what age to stop?

A

75

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16
Q

Cancer screening. Breast. age to start?

A

50

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17
Q

Cancer screening. Breast. how to screen?

A

mammography every 2 years

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18
Q

Cancer screening. Breast. age to stop?

A

75 years of age

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19
Q

Cancer screening. cervical. age to start?

A

21

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20
Q

Cancer screening. cervical. how to screen? 2

A

PAP every 3 years
OR
PAP every 5 + HPV testing every 5 years

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21
Q

Cancer screening. cervical. age to stop? 2

A

65 years of age + 3 consecutive normal PAP

Total abdominal hysterectomy

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22
Q

Cancer screening. lung. age to start?

A

55-80 yo + >= 30 pack years + quit smoking < 15 year

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23
Q

Cancer screening. lung. how to screen?

Study These Flashcards
A

low dose CT every year

24
Q

Cancer screening. lung. when to stop? 2

Study These Flashcards
A

80 yo

quit smoking > 15 years

25
Cancers which you do not screen for? 3
1. PROSTATE CANCER 2. OVARIAN CANCER 3. ENDOMETRIAL CANCER
26
Cancers which you do not screen. why not prostate?
Because of lead time bias, screening for it is useless
27
Cancers which you do not screen. in what exception ovarian?
a. Normally we do not screen for it b. However, screening should be done if the patient is BRCA positive
28
US preventive service task force rec. for breast cancers screening. Definitely beneficial: recommended?
mammogram every 2 years for women 50-74
29
US preventive service task force rec. for breast cancers screening. Possibly beneficial: individualize?
mammogram in women 40-49
30
US preventive service task force rec. for breast cancers screening. Uncertain benefit?
mammogram in women >= 75 y/o.
31
Screen medical condition. abdominal aneurysm. WHO?
Male + >=65y + ever smoked in their lifetime
32
Screen medical condition. abdominal aneurysm. how?
1-time abdomen UG CT scan of abdomen done for some other condition
33
Screen medical condition. osteoporosis. who?
Female + >=65
34
Screen medical condition. osteoporosis. how?
DEXA scan (start bisphosphonates if positive)
35
Screen medical condition. HCV. who?
baby boomers (1945-1965)
36
Screen medical condition. HCV. how?
HC antibodies
37
Screen medical condition. HIV. who?
everyone once OR anyone who ask for it
38
Screen medical condition. HIV. how?
elisa
39
Screen medical condition. HTN. who?
everyone at every visit
40
Screen medical condition. HTN. how?
ambulatory monitoring
41
Screen medical condition. DM. who?
hypertensive patients
42
Screen medical condition. DM. how?
HbA1c
43
Screen medical condition. hyperlipidemic disease. who? 3
Male >= 35 female >=45 Anyone >=20 with risk factors for CAD
44
Screen medical condition. hyperlipidemic disease. how?
lipid panel
45
Screen medical condition. depression. who?
geriatric
46
Screen medical condition. depression. how?
PHQ-9
47
Screen medical condition. mobility. who?
geriatric
48
Screen medical condition. mobility. how?
Get up and go
49
Routine adolescent screening. how often?
annually, unless otherwise indicated
50
Routine adolescent screening. mental health. method?
Validated depression questionnaire
51
Routine adolescent screening. sexual health. 3 methods?
Confidential discussion about sexual activity Gonorrhea and chlamydia testing if sexually active HIV testing (once at age <18)
52
Routine adolescent screening. substance use? 1
confidential discussion about exposure use, abuse
53
Routine adolescent screening. dyslipidemia? 1
lipid panel once between age 17 and 21
54
Routine adolescent screening. safety 2
Inquiry about bullying Inquiry about seabelt and helmet use
55
Routine adolescent screening. MCC of death?
suicide --> screen for depression
56
Routine adolescent screening. how depression can present?
o Depression can present as irritability, failure to gain an expected amount of weight, and academic decline. Also, abdominal pain and headache.
57
Routine adolescent screening. screen depression, age?
All teenagers above the age of 12 should be screened.

STEP 2 Biostats and epidemiology (14 decks)

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