Prevention in General Practice Flashcards
_________may be defined as the means of promoting
and maintaining health or averting illness
Prevention
It is concerned with removal or reduction of
risks; early diagnosis; early treatment; limitation of
complications, including those of iatrogenic origin;
and maximum adaptation to disability
Prevention
________includes action taken to avert the
occurrence of disease. As a result there is no disease.
Primary prevention
_________ includes actions taken to stop or
delay the progression of disease.
Secondary prevention
Secondary prevention applies measures for
the detection of disease at its earliest stage, i.e. in
the ___________ so that treatment can be
started before irreversible pathology is present
presymptomatic phase,
_______ includes the management of
established disease so as to minimise disability
Tertiary prevention
Conceptually, curative medicine falls within the
definitions of secondary and tertiary prevention
while _______ measures are mainly concerned
with primary prevention
public health
As GPs our role in prevention is twofold.
1 First, we can recognise the ________
that are involved in an illness process and
determine appropriate interventions.
2 Second, we can act to implement the _____
preventable factors
preventive
measure.
Conditions can be ranked in importance as causes of
premature death according to the ‘person-years of life
lost before 70 years’
- _________29%
- Neoplasms 19%
- ____________s 17%
- Perinatal conditions 10%
- ___________ 7%
Accidents, poisoning and violence
Circulatory disease
Congenital conditions
The Royal College of General Practitioners (UK)
has identified the seven most important opportunities
for prevention as:
1 family planning 2 antenatal care 3 immunisation 4 fostering the bonds between mother and child 5 discouragement of smoking 6 detection and management of raised blood pressure 7 helping the bereaved
The two most
common causes of death in Australia are ______ AND _________, each accounting for
approximately 29% of all deaths.
cancer
and cardiovascular disease
By comparison, the ten leading causes of death
in the world are (in order) ____, _______, ______, _______, _______ HIV/AIDS, cancer, diabetes
mellitus, road injury and prematurity
ischaemic heart disease,
stroke, lower respiratory tract infection, COPD,
diarrhoeal disease,
The World Health Organization (WHO) defines _________as ‘a state of dynamic harmony between the
body, mind and spirit of a person and the social
and cultural influences which make up his or her
environment
good
health
That environmental factors are involved in the
aetiology of _________ and other cancers is
indicated by wide variations in incidence between
different countries
colorectal cancer
Studies in the US indicate that at least 35% of all
cancer deaths are related to _______
diet
Obese individuals have an increased risk
1.
2.
3.
of colon, breast and uterine
cancers.
_______s are a risk factor for prostate,
breast and colon cancers
High-fat diet
Salt-cured, smoked and nitrate-cured foods increase the risk of ________
upper GIT cancers.
Overall, diet, smoking, alcohol and occupational
exposures (5%) appear to account for over _______of all
cancer mortality
73%
The development of a number of cancers appears to
be related to a depression of the individual’s___________particularly in relation to cellular immunity,
in a similar way (albeit on a different scale) to the
effect of HIV infection
immune
system,
a protective effect on the immune system may be provided by:
1
2
3
- food antioxidants
- tranquillity
- meditation
It is worth noting that the death rate from
coronary heart disease is about _______higher for
smokers than for non-smokers and for very heavy
smokers the risk is almost ________ higher.
70%
200%
GPs can estimate the absolute 5-year risks of
cardiovascular events in their patients by referring
to the New Zealand Guidelines Group Cardiovascular
Risk Charts ( www.nzgg.org.nz ).
The parameters used are:
1
2
3
4
5
- gender and age
- smoking status
- diabetes status
- blood pressure
- total cholesterol/HDL ratio
That environmental factors are involved in the
aetiology of ________ and other cancers is
indicated by wide variations in incidence between
different countries.
colorectal cancer
The development of a number of cancers appears to
be related to a depression of the individual’s immune
system, particularly in relation to _______
cellular immunity
The protective effect for asthma and COPD of
___________and other natural
antioxidants is highlighted by Sridhar.
vitamin C, fish oils, a low-salt diet
What are the 6 steps to asthma management
1 Establish the severity of the asthma.
2 Achieve __________.
3 Maintain best lung function—identify and avoid
_______
4 Maintain best lung function—follow an _____
5 Develop an action plan.
6 Educate and review regularly.
best lung function
trigger factors.
optimal
medication program.
In practice, _______ is not only to detect disease at
its earliest stage, but also to find individuals at risk or
those with established disease who are not receiving
adequate care
screening
3 levels of screening
- ________ with risk factors that predispose
to disease - _______ individuals with signs of early
disease or illnes
‘well’ individuals
asymptomatic
_______ individuals whose irreversible
abnormalities are unreported but the effects
can be controlled or assisted (
symptomatic
Important social history
1. 2 3 4 5 6 7 8
- Family history.
- Suicide and accidents.
- Substance abuse
- Exercise and nutrition
- Occupational health hazards
- Physical functioning, home conditions and social
supports. - Sexuality/contraception
- Osteoporosis.
Occupational Health Hazards:
- coal miners—
- gold, copper and tin miners—
- asbestos workers and builders—
- veterinarians, farmers, abattoir workers—
- aniline dye workers—
- health care providers—
• coal miners—pneumoconiosis • gold, copper and tin miners—silicosis • asbestos workers and builders—asbestosis, mesothelioma • veterinarians, farmers, abattoir workers— zoonoses • aniline dye workers—bladder cancer • health care providers—hepatitis B
Fractures of the_______
have a particularly poor prognosis, with up to a third
of these women dying within 6 months
femoral neck
Bone loss accelerates at the time of the menopause, and can be reduced by _______
hormone replacement therapy
Women at risk of osteoporosis are _____________; they drink coffee and alcohol, smoke,
eat a high-protein
short, slim,
Caucasian
________has been estimated to exist in up
to 15% of women aged 60 and above, and searching
for clues may elicit subtle symptoms and signs
previously attributed to ageing.
Hypothyroidism
Screening for children
Height/weight/head circumference:
- Record height from age ______ and weight at regular intervals to age 5 years
- Record head circumference at birth and then up to ________months.
3
6
Hips. Screen for congenital dislocation at birth,
_____weeks, ______ months and _____months
6–8
6–9
12–24
Screening for hip dislocation:
The flexed hips are abducted, checking for
movement and a ‘clunk’ of the femoral head forwards
(the test is most likely to be positive at _______weeks and
usually negative after _______ weeks)
_____ or ______is also abnormal.
3–6
8
Shortening or limited abduction
Strabismus should be sought in all infants and toddlers by ________ (not very sensitive), examining light reflexes and questioning parents, which must be taken very seriously
occlusion testing
