OSCE - Screening Flashcards by Ryan Hutten

What immunizations should adults be asked about during routine screening visits?

HPV
Flu
Tdap, td
Shingles (60+)
Pneumococcal: 13 or 23 valent

How well did you know this?

Not at all

Perfectly

What populations should receive PCV13 and which should receive PCV23?

PCV13: 65y+ or risk factors and immunocompromised
PPV23: smokers, asthmatics

How well did you know this?

Not at all

Perfectly

Which populations of women should be screened for cervical cancer?

Women 21-65 should get Pap smear every 3 years

Women 30-65 can get pap smear with HPV testing every 5 years

How well did you know this?

Not at all

Perfectly

Which populations of women should be screened for breast cancer?

Women 50-74 should receive mammograms every 2 years

Women

How well did you know this?

Not at all

Perfectly

Who gets screened for osteoporosis?

Women >65y or under 65 with fracture risks

How well did you know this?

Not at all

Perfectly

What is the screening test for osteoporosis?

DEXA scan = dual energy xray absorptiometry

How well did you know this?

Not at all

Perfectly

Who gets screened for AAA?

Men between 65-75y with a smoking history,should get an abdominal ultrasound. Men with risk factors are also screened (HTN, family history, overweight, atherosclerosis, caucasians)

How well did you know this?

Not at all

Perfectly

Who gets screened for colon cancer?

Men and women between 50 and 75y are screened with FOBT every year, flexible sigmoidoscopy every 5 years, and colonoscopy every 10 years

How well did you know this?

Not at all

Perfectly

Describe what a mammogram is

Your breasts are compressed between two firm surfaces to spread out the breast tissue. An X-ray captures black and white images of your breast tissue so doctors can look for signs of cancer.

How well did you know this?

Not at all

Perfectly

Should patients be taught self-breast exam techniques?

How well did you know this?

Not at all

Perfectly

What are the benefits of routine mammography screening?

Reduced mortality, especially between 60-69y

How well did you know this?

Not at all

Perfectly

What are the harms of routine mammography screening?

Psychological stress
False positives can cause more imaging, biopsies and treatment
Over diagnosis
Radiation exposure

How well did you know this?

Not at all

Perfectly

What are the risk factors for breast cancer?

Age
Genetic mutations: BRCA1/BRCA2
No pregnancies
Late age of first pregnancy
No breastfeeding
Obesity
Early menarche/ Late menopause (Estrogen)

How well did you know this?

Not at all

Perfectly

What is the treatment for breast cancer?

Radiation
Chemotherapy
Surgery

How well did you know this?

Not at all

Perfectly

What is considered adequate screening for cervical cancer?

3 consecutive negative cytology results or 2 consecutive negative HPV tests in a woman over 65 years old all within the previous 10 years

How well did you know this?

Not at all

Perfectly

What are the benefits of routine cervical cancer screening?

Decreased cervical cancer incidence and mortality

How well did you know this?

Not at all

Perfectly

What are the harms of routine cervical cancer screening?

Abnormal results lead to more testing and invasive diagnostic procedures which can cause vaginal bleeding, pain, infection, and inadequate sampling
Increased anxiety/distress
Treatment associated risk
Overdiagnosis (non-clinically significant cancers)

How well did you know this?

Not at all

Perfectly

What are the risk factors for cervical cancer?

Study These Flashcards

HPV infection
HIV infection (compromised immune system)
Smoking
Many sexual partners, early sexual activity, STI hx
DES exposure in utero
Previous high grade precancerous lesion or cervical cancer

What are the treatments for cervical cancer?

Study These Flashcards

Ablation, excisional therapy for high grade precancerous lesions
Hysterectomy or radiation for cancer

Describe FOBT

Study These Flashcards

Test for looking for blood in stool

A spoon/collecting device used to get stool sample which is placed on a card that is sent to doctor or lab

Describe sigmoidoscopy

Study These Flashcards

A thin flexible tube inserted into the rectum and advanced into colon with a camera at the tip
Looks for polyps/abnormal tissue in the rectum and colon
Requires bowel prep with laxative or enema and may require medication adjustments
Takes about 15 minutes

Describe a colonoscopy

Study These Flashcards

A long flexible tube inserted into the rectum with a camera at the tip
Looks for polyps/abnormal tissue in rectum and colon
Requires bowel prep with laxative or enema
Requires sedation
You will need someone to drive you home

What are the benefits of routine colon cancer screening?

Study These Flashcards

Reduced cancer mortality

Less invasive tests reduce number of colonoscopies even though abnormal results require follow up colonoscopy

What are the harms associated with colonoscopy?

Study These Flashcards

Perforation of the colon (4/10,000)
Serious complications (major bleeding, severe pain) 25/10,000
Poor reaction to sedative

What are the harms associated with flexible sigmoidoscopy?

Serious complications (major bleeding, severe pain) 3/10,000

What are the risk factors for colon cancer?

``` Family Hx Inherited syndromes Inflammatory bowel disease Obesity Smoking Alcohol Lack of physical activity African american race ```

What are the guidelines for screening for lung cancer?

Individuals 55-80y with a 30 pack year smoking history that are actively smoking or quit within the past 15 years should receive a low dose CT yearly Stop when quit date is 15y ago Stop when costs outweigh benefits of screening

What harms are associated with routine lung cancer screening?

``` False negatives False positives Incidental findings Overdiagnosis Radiation exposure ```

What are the risk factors for lung cancer?

``` Smoking Age > 55y Occupational exposures Radon exposure Family history COPD or pulmonary fibrosis ```

What are the treatments for lung cancer?

Surgical removal (early non-small cell lung cancer) Chemotherapy Radiation

Describe DEXA scans

Imaging to detect decreases in bone density Painless Low radiation exposure Takes about 10 to 30 minutes

What is the benefit of routine DEXA scan?

Prevents osteoporosis related fractures, chronic hip pain, disability, loss of independence and mortality

What are the harms of DEXA scans?

``` False positives False negatives Anxiety Cost Time ```

What are the risk factors of osteoporosis?

``` Females White women Age Low BMI Early menopause Parental history of hip fracture Smoking Alcohol Corticosteroid use ```

What are the treatments for osteoporosis

Medications: bisposphonates, PTH, raloxifene, estrogen, calcitonin Calcium - 1500mg Vitamin D - 800 IU

What are the guidelines for screening for ovarian cancer?

Do not screen | -No mortality benefit by screening with transvaginal ultrasound and CA-125 serum testing

What are the risk factors of ovarian cancer?

BRCA mutation Lynch syndrome (HNPCC) Family history

What factors decrease risk of ovarian cancer?

``` Oral contraceptive use Pregnancy Breastfeeding Bilateral tubal ligation Removal of ovaries ```

What are the screening guidelines for prostate cancer?

Do not screen with PSA | Identifies too many non-clinically significant cancers

What are the risk factors for prostate cancer?

``` Age Black men Family history of prostate cancer Exposure to agent orange BPH is NOT a risk factor Prostatitis Smoking ```

What are the treatments for prostate cancer?

Surgery Radiation Androgen deprivation therapy

What are the screening guidelines for testicular cancer?

Do not screen | Very little benefit because most cases are found incidentally

What are the risk factors for testicular cancer?

Cryptorchidism History of testicular cancer Trisomy 21 Klinefelter

What are the treatments for testicular cancer?

Orchiectomy Radiation Chemotherapy >90% of newly diagnosed cases are cured

OSCE - Screening Flashcards

(44 cards)