Preventative Medicine Flashcards
(34 cards)
What are the four malignancies for which regular screening is recommended?
- colon
- breast
- cervix
- lung
What are the guidelines for colorectal cancer screening?
- If no significant family history, start at 50 (or 45)
- If single first-degree reative <60 start at 40 or 10 years before relative was diagnosed
- gFOBT every 1 year
- FIT every 1 year
- FIT-DNA every 1-3 years
- CT coongraph every 5 years
- flexible sigmoidoscpy every 5 years
- colonography every 10 years
What are the guidelines for breast cancer screening?
- mammography every 1-2 years from 50-74
What are the guidelines for cervical cancer screening?
- starting age 21 Pap smear every 3 years until 65
- Pap smear +HPV testing every 5 years, age 30-65
What are the guidelines to screen for lung cancer?
- low-dose CT every 1 year for adults 50-80 with 20-pack-year smoking history and currently smoke or have quit within 15 years
What age do we start screening for osteoporosis?
What sites are most commonly used?
- > 65
- spine, hip, forearm
What factors increased risk of osteoporosis and therefore require screening earlier?
- parental history of hip fracture
- smoking
- alcohol use
- low body weight
What are the Z-score and T-score?
- Z-score: compares bone density to peers
- T-score: compares bone density to healthy young adult
How is osteoporosis/osteopenia diagnosed?
- osteopenia: T-score of -1 to -2.5
- osteoporosis: T-score -2.5 or lower
Initial treatment plan for patients with osteoporosis?
- start bisphosphanates
- oral daily calcium supplementation
- vitamin D
What are the guidelines for cholesterol screening?
- men with no risk factors for coronary artery disease: 35
- men & women with risk factors: routinely after 20
- low-risk individuals: repeat in 5 yrs
What are the diagnostic criteria for Diabetes Mellitus?
- two fasting glucose measurements >125
- HbA1c >6.5%
- random glucose >200mg/dL with symptoms
What are the symptoms of Dibetes Mellitus?
- frequent urination
- extreme thirst/dry mouth
- fatigue
- increased appetite
- unexplained weight loss
What are the screening guidelines for Diabetes Mellitus?
- asymptomatic + overweight: 33-70
- asymptomatic + hypertension, hyperlipidemia, first degree relative with DM
- everyone >18 with elevated blood pressure (at every visit)
What are the screening guidelines for abdominal aortic aneurysm?
men 65-75 who have ever smoked
What are recommendations for the following vaccine + travel?
Hepatitis A
all travelers to developing nations
* if departing within 2 weeks, give vaccine + immune serum globulin
* booster shot 6 months later (immunity 10 yrs)
What are recommendations for the following vaccine + travel?
Hepatitis B
all people traveling to areas of high prevalence + plan to receive medical/dental care while there (including tattoo & acupuncture)
What are recommendations for the following vaccine + travel?
typhoid
traveling to developing nations & will have prolonged exposure to contaminated food and water
* live attenuated: 4 doses given orally repeated every 5 yrs
* capsular polysaccharide (preferred): given IM 1x & repeated every 1-2 yrs
What are recommendations for the following vaccine + travel?
polio
those traveling to developing nations
* if not previosly vaccinated: 3 doses of inactivated vaccine
* if previously vaccinated: one-time booster
What are recommendations for the following vaccine + travel?
Rabies
were rabies is common among domesticated animals
(India, Asia, Mexico)
What are the guildelines for malaria prophylaxis for traveling? Slide effects?
- mefloquine (1x/week) - neuropsychiatrics effects ie. hallucinations, depression, unusual behavior
- doxycycline acceptable alternative - photosensativity
- chloroquine in pregnancy
What are the guidelines for Tdap vaccination in US?
most receive primary immunization as child - for those that do no, give 3 doses
* first 2 doses 1-2 months apart (first should be Tdap, all others can be Tdap or Td)
* third dose 6-12 months later
* booster every 10 yrs for life
* if patient receives dirty wound, revaccinate after 5 yrs
What are the guidelines for pneumococcal vaccination in the US?
- all adults >65
- sickle-cell disease or asplenia
- cardiopulmonary disease, cirrhosis, diabetes, alcoholism, cigarette smoking
- immunocompromised status
- booster dose for patients <60 when they received primary dose
What are the guidelines for Hepatitis B vaccination in US?
- all children though age 18
- those with STIs
- Sexually active but not monogomous
- occupational exposure to blood
- prison inmates
- travelers to countries endemic with hep B
- history IV drug use
- HIV infection
- MLM sexual contact
- history chronic liver disease
