Flashcards in Lecture 3- Health Promotion/Preventative Medicine Deck (38):
Why do geriatric prevention/health maintenance?
- Improves disability free life expectancy
- Increases function- (ADLs and IADLs)
- Improves Health Quality of Life
Why is disease prevention important from a financial standpoint?
- we miss 55 billion dollars worth of prevention opportunities, while instead doing 210 billion dollars worth of unnecessary services... we could be so much more efficient
What does the U.S. Preventative Services Task Force (USPSTF) do?
- Determines whether or not evidence supports providing a clinical preventive service
- Rated as A,B,C,D, and I
How do interpret USPSTF ratings
- anything rated A and B- should discuss those services with eligible patients and offer them
- C- clinician may provide this service to selected patients
- Discourage anything with a D rating
- I rating means that the evidence of that service's effectiveness is lacking and of poor quality.
The Screening tests that have an A and B rating (large list)
- Abdominal Aortic Aneurysm Screening
- Alcohol Misuse counseling
- Aspirin to prevent cardiovascular disease
- Blood pressure screening
- BONE MASS MEASUREMENT
- Cardiovascular screening
- Depression screening
- Colorectal cancer screening
- Diabetes screening
- Flu shot
- Fall prevention
- Healthy Diet Counseling
- Healthy diet counseling
- Glaucoma Test
- Hepatitis B Shot
- HIV Screening
- Medical nutrition therapy services
- obesity screening and counseling
- PAP AND PELVIC EXAM
- pneumococcal shot
- smoking cessation counseling
- STD Counseling
Cancer screenings- It is recommended to screen for what cancers?
- Gynecologic cancers - breast and cervical
- Osteoporosis - bone mass measurement
- prostate cancer
- colon cancer
Chance of developing breast cancer at age 50 and age 80
age 50- 1 in 50
age 80- 1 in 8
more than _____ of breast cancer deaths occur among women over the age of 65
What percentage of all cancers are preventable?
USPSTF recommendations for mammogram
- Biennial screening mammography for women aged 50-74
- Grade B recommendation
- hard to know the effectiveness of this in women over 75- this is rated I
What is teaching breast self-examination (BSE) rated?
What is a clinical breast exam in women over 40 rated
What is the use of digital mammography or MRI instead of film mammography for screening for breast cancer rated?
Breast cancer screening guidelines from the ACS- American Cancer Society
- Start mammograms at age 45
- for women over 55, should do biennial screening, with the option for yearly
- Annual screening mammography should be offered to patients between 4- and 44
- Clinical breast exam not recommended as a screening approach for breast cancer
HPV is found in _______ of all cervical cancers (young and old)
USPSTF recommendations for cervical cancer
21-65- cytology (Pap smear) every 3 years
30-65- Combination of Cytology and HPV testing every 5 years
Given an A recommendation!
What does the USPSTF NOT recommend for cervical cancer screening
- Do not screen for cervical cancer in women over 65 who have had adequate prior screening and not at high risk for cervical cancer
What is considered "adequate screening" for cervical cancer
- 3 consecutive negative cytology tests or
- 2 consecutive negative HPV/Pap co-tests in the 10 years prior to stopping
Which of the following statements about cervical cancer screening is correct?
A. Screening may be stopped in women 65 years and older only if they have previously had a hysterectomy
B. Screening should continue until 75 years of age
C. Screening should continue until 75 years of age, but testing for HPV infection should not be part of the screening
D. Screening May be stopped in women 65 years and older if they have had adequate prior negative screening results
USPSTF recommendations for Osteoporosis
- recommends screening in women over 65 and in younger women whose fracture risk is equal or worse to that of a woman aged 65
- B Rating
- For men, there is not sufficient evidence to evaluate the value of this screening in men-
- I rating
Major risk factors for osteoporosis
- weight of less than 60 kg- the single best predictor of low bone density
- Family History
Prostate cancer risk factors
- African American
- Family History- first degree relatives only
It is not known whether a PSA screening will reduce the risk of death from prostate cancer
-PSA can be elevated in cases of prostatitis or BPH
USPSTF rating for PSA screening for prostate Cancer
Despite the rating, ______ o f men with limited life expectancy continue to receive PSA
How many PSA tests are done annually?
How many of those PSA tests will be found to have elevated PSA levels
6 million- and 1 million of them will undergo a prostate biopsy
Of those who have prostate biopsy, how many will be diagnosed with prostate cancer?
How many will have prostate cancer that the biopsy missed?
How many men with low-risk cancers will undergo surgery or radiation anyway, probably unnecessarily
Which statement is correct about PSA testing to screen for Prostate cancer?
A. The American Urological Association recommends shared decision making for men 55-69 years old
B. American urological association recommends annual screening for men 50-74 years of age
C. The U.S. preventative services task force recommends routine screening for all men aged 40-74 years
D. U.S. and Europe studies show there is a moderate reduction in prostate cancer mortality in men who undergo prostate-specific antigen screening
Colon Cancer risk is higher in what demographic?
African American Men!
____ of colon cancers occur after age 50
Colorectal cancer screening recommendations
screening using fecal occult blood testing, sigmoidoscopy, or colonoscopy beginning age 50 and continuing until age 75
- A recommendation
The USPSTF is against colon cancer screening with FOBT/Sigmoidoscopy/colonoscopy in adults ______
more than 85 years old
- D recommendation
Which of the following is a USPSTF recommendation for colorectal cancer screening in older patients
A. Screening should continue until life expectancy is 10 years or less
B. Routine screening is recommended from 50-75
C. There is no age limit for screening, although only fecal occult blood tests should be used after 75 years of age
D. Screening is not recommended for any patient 75 years or older
Other Recomendations for secondary prevention
- cognitive impairment screening
- Glaucoma screening
- TSH in women