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Flashcards in Health Screening Deck (45):
1

when should colonoscopy screening begin for people w/ no family hx

age 50

2

when is colonoscopy screening stopped?

when age expectancy is less than 10 yaers

3

three screening option for adults >50 for colorectal cancer

annual fecal occult blood testing (FOBT)
flexible sigmoidscopy every 5 years w/ FOBT every 3 years
colonoscopy every 10 years

4

who should receive a PAP smear

women aged 21-65 who have a cervix

5

when should pap smears be done for average-risk women age 21-29

at three year intervals

6

when should pap smears be done for women age 30-65

Pap every 3 years of pap plus HPV every 5 years if both inital tests are negative

7

who should get bone mineral density testing?

women 65 and older , men with hx of fractures and other potential risks of osteoporosis

8

what screening test is used for osteoporosis

DXA of the hip and spine

9

most common clinical manifestation of osteoporosis

vertebral fracture (2/3 are asymptomatic)

10

what is an osteopenic T score?

1-2.5 standard deviations below the young adult mean

11

what is an osteoporotic T score?

2.5 standard deviations or more below the young adult mean BMD

12

what is a Z score?

comparision of the patient' BMD to an age-matched populations

13

what Z score is below the expected range for age?

-2.0 or lower (look for xo-exisiting problems that can contribute to osteoporosis

14

how much calcium should postmenopausual take *supplemental)

500-1000 mg/day in divided doses

15

how much Vitamin D should postmenopausal women take?

800 international units dialy

16

First line therapy for postmenopausual women w/ osteoporosisi

alendronate or risedronate or IV if they can't tolerate these

17

what is the only IV bisphosponate that has demonstrated efficacy for fracture prevention and is the agent of choice?

zoledronic acid

18

what is a monoclonal antibody used to treat osteoporosis. It is administered subQ

denosumab

19

clinical manifestation of chronic adrenal insufficiency

weakness, fatigue, anorexia, N/V/C/D, salt craving, posturnal diziness, Hypotension, hyperpigementations

20

electrolyte distrubances seen with chronic adrenal insufficiency

hyponatremia
hyperkalemia

21

Tx for acute adrenal crisis

hydrocortisone

22

how does someone with hyperaldosteronism present?

hypertension and hypokalemia

23

Tx of primary aldosteronism

normalize BP and serum potassium with spironolactone and potassium supplements
definitive tx is surgery to remove the adenoma (most common cause)

24

risk factors for hyperlipidemia

smoking, HTN, DM< advanced age, family history

25

what does dylipidemia mean

elevated LDL and low HDL

26

what is an acute phase reactant tha tincreases during inflammation and is a moderate predictor for CHD risk independent of other major CHD risk factors

C-reactive protein (CRP_

27

how much does cholesterol increase on average per year

2 mg/dL in early adult hood

28

does caloric excess raise cholesterol or triglycerides more

triglycerides

29

what med for HTN can increase LDL temporarily

thiazide diuretics

30

what med can reduce HDL cholesterol and increase serum triglycerides (cardiac med)

beta blockers

31

what are some causes of secondary hypercholesterolemia

hypothyroidism, nephrotic syndrome, obstructive liver disease

32

when should patients get a fasting lipid profile

everyone older than age 20

33

what is a desirable ratio of total cholesterol to HDL cholesterol

4.5

34

if LDL is high and HDL Is low what drug (that is also a vitamin) can be used?

Niacin

35

individuals with the highest risk (CHD< DM) should have an LDL goal of what?

<70

36

What can increased HDL?

aerobic exercise, smoking cessation, weight loss

37

what drugs are good for elevated triglycerides

gemifibrozil, fenofibrate

38

a fibrate plus a statin can lead to what

increase risk of rhabdomyolysis

39

who should get TSH screening

Women >50, who have had external neck irradiation, thyroid surgery, newly pregnant women

40

if the patient appears clinically and biochemically hypothyroid but the TSH isn't elevated what shoudl be done

test for pituitary insufficiency

41

how long does it take for a new dose of levothyroxine to take effect?

4-6 weeks

42

first line tests for cushings

late night salivary cortisol, urinary cortisol and low-dose dexamethasone supression tests

43

most common cause of cushing's

iatrogenic due to pharm doses of glucocorticoids

44

clinical manifestations of cushing's

supraclavicular fat pads
centripetal obesity
hirsutism
skin atrophy
wide purplish striae
proximal muscle weakness

45

drugs to tx cushing's due to a ACTH tumor that wasn't cured by pituitary surgery

cabergoline or pasireotide