Periodic Health Examination Flashcards
(21 cards)
Periodic Health Exam General Population discussion
Dental Hygiene
Hearing protection
Poverty screen
Sun exposure
Smoking cessation
Problem drinking
STIs
Dietary advice (leafy greens, fat, cholesterol, calcium, vitamin D) and physical activity
Seat belt use and injury prevention
General Population periodic health exam physical exam
Blood pressure
BMI measurement
PHE general population therapy
Folic acid to women of child-bearing age
HTN treatment
Varicella vaccine (susceptible adults and children 1-12)
Rubella vaccine (non pregnant women of child bearing age unless proof of immunity)
Tetanus vaccine (q10y)
Pertussis vaccine (<65 years should receive one booster)
Herpes zoster vaccine (60 years +)
Folic acid supplementation dosing in pregnancy
Low risk (no personal health risks, planned pregnancy) -
0.4-1 mg daily
At least 2-3 months before conception
Throughout pregnancy and postpartum period
High risk (epilepsy, insulin dependent diabetes, BMI>35, family history NTD)
5 mg daily
At least 3 months prior to conception to 10-12 weeks post conception
Then 0.4-1 mg 12 weeks post conception until 4-6 weeks postpartum or as long as breastfeeding continues
Pediatric periodic health exam physical exam
Repeated examinations of hips, eyes, hearing (esp first year)
Serial height, weight, HC
Visual acuity after age 2
Periodic health exam therapy that should be offered to TB high risk groups
INH prophylaxis for household contacts or skin test converters
INH prophylaxis for high risk sub-groups
Periodic health exam therapy that should be offered to Immunocompromised Age 65+ COPD Asthma CHF Asplenia Liver Disease Renal Failure DM
Pneumococcalvaccine (Pneumovax)
Breast cancer screening guidelines
Average risk women age 40-74:
Mammography - routine screening q 2-3y age 50-74 and 75+ potentially (take overall health into account)
MRI - no routine screening
CBE - no routine
Breast self examination - no routine
What makes a woman average risk for breast cancer?
No personal history of breast cancer
No history of breast cancer in 1st degree relatives
No known BRCA1/BRCA2 gene mutations
No previous chest wall radiation exposure
Lung cancer screening guidelines
Annual screening with low dose CT for adults aged 55-74
with minimum 30 pack year smoking history
Who currently smoke or quit <15 years ago
Up to 3 consecutive times
Colorectal cancer screening guidelines
Average risk:
FOBT or FIT q2y or flexible sigmoidoscopy q10y and no colonoscopy as a screening test
No screening after age 75 for average risk patients, but assessed on individual basis for age 76-85
What puts someone at average risk for colorectal cancer
Asymptomatic
No family history of UC, polyps, CRC
High risk colorectal cancer screening guidelines
TN FM4
Cervical Cancer Screening Ontario guidelines
Women age 21+ with history of sexual activity (includes intercourse or digital/oral activity with partner of either sex)
Screen q3y with normal cytology
Age 70+ : if 3 successive negative Pap tests in last 10 years discontinue screening
Exceptions to guidelines:
Discontinue screening if hysterectomy for benign disease and no history of cervical dysphasia or HPV infection - continue to swab vaginal vault if history of uterine malignancy/dysplasia
Immunocompromised
Previously unscreened patients
Pap smear result algorithm
TN FM 5
Prostate cancer screening
Screening for prostate cancer with PSA is not recommended for any age group
Can screen if strong family history
Stages of change and steps that should be taken for each
Pre-contemplation - assess readiness, increase awareness
Contemplation - encourage change, build confidence, pros and cons discussion
Preparation - explore options, develop strategies to prevent relapse
Action - design rewards
Maintenance - discuss progress and signs of impending relapse
Relapse - view as learning experience, reassess readiness to change
Vitamin D recommendations in Canada
1000 IU per day in fall and winter
High risk - 1000 IU all year around
Older, dark skin, indoors, usually covered
Babies exclusively breast-fed - 400 IU/d
Vitamin D intake recommendations
800-1000 IU if <50 years old
800-2000 IU if 50+ years old
Calcium intake recommendations
1000 mg daily 19-50 years old and pregnant/lactating
1200 mg daily for >50 years old
Alcohol recommendations
0-3 drinks/d, max 15/week for men
0-2 drinks/d, max 10/weeks for women
