Preventative Health Screening Flashcards
(35 cards)
what is the USPSFT?
the United States Preventitive Services Task Force (USPSTF)
- an indepednent panel of experts in primary care that make screening recommendations which are considered the “gold standard” for clinical prevention
explain that grading system of the USPSTF grading sytem
- A = there is a high certainty that there is a substantial benefit of using this recommendation
- B = there is high certainty that the net benefit is moderate
- C = consider, offer this recommendation
- D = moderate/high certainty that the service has no net benefit/has harms that outweight benefits
- E = not enough evidence
what are the suggestions of practice for each grade of the UPSPTF grading system?
- A and B = offer or provide this service
- C = offer or provide this service for selected patients depending on individual circumstances
- D = discourage use of this service
- I = not enough evidence.
who are considered first degree relatives of an individual?
The parents, brothers, sisters, or children of an individual.
what three criteria are important when deciding what conditions to screen for?
• Burden of suffering caused by the condition (is what they’re experience bad enough to warrent screening?
• Effectiveness, safety, and cost of the preventive
intervention or treatment
• Performance of the screening test:
- *Sensitivity**-the true positive rate
- *Specificity**-the true negative rate
how prevalent/preventable is CVD?
who should be screened for hypertension?
Screen ALL adults aged 18 years or older (A)
discuss the USPSTF recommendations of screening for hypertension in terms of
- who to screen?
- what do obtain before starting treatment?
- at what intervasl to screen certain populations
- screen all adults 18 or older
- USPTF recommends measurements outside of a clinical setting before starting treatment
- ABPM: abmulatory BP
- HBPM: home BP
- screen interval:
- annual screening for
- for adults 40 yrs or older, or
- those with increased risk of high BP
- overweight, obse, AA
- every 3-5 years for
- those under 40 (but over 18) with normal BP (135/80) who do not have other risk factors
- annual screening for
in an asymptomatic patient - should we screen for CVD with an EKG?
no.
the UPSTF against screening with resting or exercise electrocardiography (ECG) to prevent cardiovascular disease (CVD) events in asymptomatic adults at low risk of CVD events. (Grade D)
when should we screen patients who use tobacco for CVD?
always
what are the 5 As of smoking cessation?
1) ASK every patient about tobacco use
2) ADVISE all tobacco users to quit
3) ASSESS their willingness to attempt to quit
4) ASSIST with attempts to quit
5) ARRANGE follow-up
what the does USPSTF recommend in terms of screening for abdominal aortic aneurysms (based on age, gender, medical hx, ect)
Recommendations:
- 1-time screening with ultrasonography in MEN aged 65-75 years who have ever smoked (Grade B).
- Men who have never smoked- Clinician selection (C)
- Recommends AGAINST screening for AAA in women who have never smoked (D)
- Women who have smoked-evidence is inconclusive (I)
what does the UPSTF recommends
what does the USPSTF recommend for screening for carotid artery stenosis (CAOD)?
recommends AGAINST screening for CAOD in an asymptomatic adult population (Grade D)
what are the USPSTF screening recommendations with regards to diabetes?
- screen for abnormal blood glucose as a part of a CV risk assessment in adults aged 40-70 years who are overweight/obsese
what does the USPSTF recommend in terms of screening for lung cancer?
- annual screening for lung cancer with low-dose computed tomography (LDCT) in adults from 50-80 years who have a 20 pack-year AND currently smoke/have quit within the past 15 years
- screening should BE stopped:
- once a person has not smoked for 15 years
- develops a health problem that substantially limited life expectancy or the ability/willingess to have curative lung surgery
- __Grade B
what does the USPTF recommend in terms of screening for breast cancer?
- Mammogram every 2 years for women 50-74 (Grade B)
- Women between 40-49 - who place a higher value on the potential benefit than the potential harms- may choose to begin biennial screening (Grade C)
- 75 years or older - insufficient data (I)
- NOT recommended:
- SBE (self breast exam)
- Other modalities not recommended above mammography
what breast cancer screening protocol the American Cancer Society (ACS) recommend for women with average risk of breast cancer
- guidlines for women of average risk for breast cancer:
- age 40-44: have the choice to start annual mammograns if they choose
- age 45-50: should get annual mammograms
- age 55+: screening should continue as long as they remain in good health/are expected to live for at least 10 years.
- for this age group, should get mammograms at least every 2 years, but can do annual screenings if they choose.
what breat cancer screening protocol does the _American Cancer Societ_y recommend for high risk women and what does consitutes high risk?
- women who are at a high risk for breast cancer based on the following factrors should get a breast MRI and a mammogram every year starting at 30:
- have a lifetime risk of 20-25% or greater based on family history
- have a known BRCA1 or BRCA2 mutation
- have a first degree relative with BRCA1/BRCA2
- had radition therapy to the chest between between 10-30 years or age
- have li-fruamen, cowden syndrome, bannayan riley or ruvalcaba syndrome
the american cancer society recommends against MRI screening for which women?
those whose lifetime risk is less than 15%
the USPSTF recommends cervical cancer screening (and what KIND of cervical screening) for which populations
hrHPV = high risk papilloma virus testing
- for women aged 21-29:
- screen every 3 yrs w/ cervical cytology
- for women aged 30-65: screen either
- every 3 yrs w/ cervical cytology, or
- every 5 yrs w/ hrHPV testing alone, or
- every 5 years with combination w/hrHPV testing + cytology testing (= cotesting)
note that this recommendation is INDEPENDENT of sexual history.
what USPSTF recommends against cervical cancer screening for which populations?
- against screening women > 65 years with adequate prior screening and are not at high risk
- adequate prior screening is either of the following within the past 5 years:
- 3 consecutive negative cytology results
- 2 consecutive negative co-testing results
- adequate prior screening is either of the following within the past 5 years:
- against screening women for who have had a hysterectomy/their cervix removed
what does the USPSTF recommend for colorectal cancer (CRC) screening?
starting at age 50-75 yrs
what does the USPSTF recommend in terms of Colon Cancer Screening (CRC)?
- Recommends screening for colorectal cancer starting at age 50 years-75 years. (Grade A)
- Age 76-85: individualized (C)
- > 85 NOT recommended (D)
