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Foundations Exam 3 COPY > Preventive 2 > Flashcards

Preventive 2 Flashcards

1
Q

What is a vital component of secondary prevention?

A

Screening (appropriately)

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2
Q

Who makes evidence based recommendations about clinical preventive services (including screening)?

A

United States Preventive Services Task Force (USPSTF)

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3
Q

Which grade(s) suggest offering/providing service?

A

A & B

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4
Q

Which grade(s) recommend offering the service based on the individual’s circumstances? (professional judgement / patient preference) (has no risk or harm and should involve pt in decision to screen)

A

C

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5
Q

In which grade(s) is it recommended to discourage the service/screening? (potential harm/outweighs benefit)

A

D

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6
Q

Which grade(s) pertains to insufficient evidence for doing the screening? (no opinion, pt should understand that benefit or harm is undetermined)

A

I

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7
Q

Which grades are covered under the Affordable Care Act?

A

A & B (high to moderate certainty of improved pt outcomes/net benefit)

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8
Q

What are the other 2 main organizations who make recommendations for screening?

A

American Cancer Society (ACS)
&
Specialty Medicine Organizations

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9
Q

What are the 3 ways in which screening decisions are made?

A

Burden of suffering
Screening test
Prevention (1,2,3)

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10
Q

What are the 6 D’s of suffering?

A
  • Death
  • Disease
  • Disability
  • Discomfort
  • Dissatisfaction
  • Destitution
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11
Q

What are harms of screening?

A
  • Risks
  • Anxiety
  • Additional dx testing
  • Over diagnosing
  • Pt becoming aware of conditions which have no tx
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12
Q

What is over-diagnosing?

A

When making the diagnosis would have no impact on overall health
Ex: prostate cancer in 80 yr old man

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13
Q

Which organization recommends screening for CVD - HTN every 3-5 years until age 40, and then annually after 40?

A

USPSTF

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14
Q

Which organization recommends screening for CVD - HTN 3 yrs of age or older w/every health care episode?

A

AAP

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15
Q

Which 3 organizations recommend screening for CVD - HTN annually beginning at age 3 yrs?

A

NHLB
Bright Futures
AHA

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16
Q

Which organization states there is insufficient evidence (Grade I) for screening CVD - HTN in children & adolescents?

A

USPSTF

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17
Q

Which organization recommends annual screenings for people at increased risk of CVD - HTN? (HTN, obese, blacks)

A

USPSTF

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18
Q

A 10 risk calculation of 7.5% or greater signifies what? How is it calculated?

A

Increased risk

Calculated by age, sex, race, tobacco use

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19
Q

What is the grade given by the USPSTF for screening for CVD - Hyperlipidemia in persons under 20 years old?

A

I = insufficient evidence

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20
Q

What is the grade given by USPSTF for ages 40 - 75 screening for hyperlipidemia with no hx of CVD, >1 CVD risk factor & 10 year CVD risk >10%

What prevention is recommended and what level is it?

A
  • Grade B
  • Low-moderate dose of Statin
  • Primary Prevention
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21
Q

If the CVD risk for hyperlipidemia is 7.5% - 10% in ages 40-75, what is the grade given?

A

C

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22
Q

What grade is given for ages 76+ & w/no hx of CVD screening for hyperlipidemia

A

I=insufficient evidence

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23
Q 
USPSTF - CVD
No hx of coronary heart disease
hs-CRP
ankle-brachial index
coronary artery calcification score
What grade?
A

I = insufficient evidence

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24
Q

USPSTF - CVD - Coronary Heart Disease
Using EKG (resting or exercise)
What is the grade for “low risk adults”?
What is the grade for intermediate/high risk adults?

A

D

I = insufficient evidence

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25
Q

USPSTF - CVD - Carotid Artery Stenosis
-10% of ischemic strokes caused by CAS
-1% of CAS is asymptomatic
What grade?

A

D (NOT RECOMMENDED to screen), this one is unfortunately screened too much (inappropriately)

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26
Q

USPSTF - CVD - AAA
MEN, 65-75 y/o ever smoked
What grade?

A

B (1 time screening w/ US)

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27
Q

USPSTF - CVD - AAA
MEN, 65-75 y/o never smoked
What grade?

A

C (selectively offer screening as opposed to routine)

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28
Q

USPSTF - CVD - AAA
WOMEN, 65-75 y/o ever smoked
What grade?

A

I = insufficient

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29
Q

USPSTF - CVD - AAA
WOMEN, 65-75 y/o never smoked
What grade?

A

D (not recommended)

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30
Q

What sex is recommended for screening of AAA regardless of smoking hx?

A

MEN, so do not screen women

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31
Q

CVD - Peripheral Artery Disease
Risk assessment w/Ankle Brachial Index
What grade?

A

I = insufficient evidence

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32
Q

CVD - ASA prophylaxis to prevent CVD & colorectal cancer.
Adults 50-59 y/o who have greater than 10% risk, no risk for bleed, life expectancy of 10 yrs, & WILLING to take low dose ASA daily for 10 years
What grade?

A

B

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33
Q

CVD - ASA prophylaxis to prevent CVD & colorectal cancer.
Adults 60-69 y/o, w/greater than 10% risk, life expectancy 10 yrs, WILLING to take low dose ASA daily for 10 yrs
What grade?

A

C

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34
Q

CVD - ASA prophylaxis to prevent CVD & colorectal cancer.
Adults younger than 50 y/o
What grade?

A

I = insufficient evidence

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35
Q

CVD - ASA prophylaxis to prevent CVD & colorectal cancer.
Adults 70 or older.
What grade?

A

I = insufficient evidence

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36
Q

USPSTF recommendations for Colorectal Cancer.
Adults 50-75 y/o
What grade?

A

A

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37
Q

USPSTF recommendations for Colorectal Cancer.
Adults 76-85 y/o
What grade?

A

C

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38
Q

USPSTF recommendations for Prostate Cancer - PSA as of May 2018.
Age 70+
What grade?

A

D

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39
Q

USPSTF recommendations for Prostate Cancer - PSA as of May 2018.
Age 50-69
What grade?

A

C

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40
Q

What are the benefits of screening for prostate cancer?

A

Very little benefits.
A large US study showed no benefit.
A large European study showed 1/1000 avoid death from screening

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41
Q

What are the potential harms of screening for prostate cancer?

A
  • False +
  • Effects of biopsy
  • Overdiagnosis/over tx
  • Effects from tx (ED, urinary/bowel issues, deaths from surgery complications)
42
Q

USPSTF recommendations for Skin Cancer COUNSELING of young adults, adolescents, children, parents of young children w/fair skin to minimize UV radiation
Ages 6mo - 24yrs
What grade?

A

B

43
Q

USPSTF recommendations for Skin Cancer COUNSELING/Screening? of adults over 24 y/o
What grade?

A

C

44
Q

USPSTF Breast Cancer, average risk
Ages 40-49
What grade?

A

C

45
Q

USPSTF, Breast Cancer, average risk
Ages 50-74
What grade? How often?

A

B, every 2 years

46
Q

ACOG, Breast Cancer screening recommendation

A

Begin offer at 40, start screening no later than 50

47
Q

ACOG, Breast Cancer screening recommendation, how often?

A

Every 1-2 yrs until 75 y/o, then discuss continuation

48
Q

Breast cancer, high risk

A

Annual screening mammogram starting at 25 y/o (or, if a relative had cancer diagnosed at 30, start screening the individual 5-10 years before 30 years of age) so like, 20-25 y/o

49
Q

USPSTF - Cervical Cancer as of Aug 2018
Women 21-29 y/o, screen for what? How often?
What grade?

A

Cervical Cancer & Cervical Cytology alone every 3 years

A

50
Q

USPSTF - Cervical Cancer as of Aug 2018
Women 30-65 y/o, screen for what? How often?
What grade?

A

Cervical Cytology alone every 3 years

A

51
Q

USPSTF - Cervical Cancer as of Aug 2018
Women 30-65 y/o, screen for high risk human papillomavirus (hrHPV) How often?
What grade?

A

Every 5 years

A

52
Q

Should women under 30 y/o receive HPV screening?

What grade?

A

No

D

53
Q

What grade for screening women under 21 for cervical cancer?

A

D (do not screen)

54
Q

What grade for screening women who had had hysterectomy for cervical cancer?

A

D

55
Q

USPSTF - Lung Cancer
Adults 55-80 y/o w/hx of smoking
What grade?

A

B

56
Q

Annual screening for lung cancer of adults 55-80 y/o is recommended with what pack-year hx?
And if the adult has quit smoking within how many years?
What grade?

A

30 year pack hx
Within past 15 years (20 would not work)
Grade B

57
Q

When should we stop screening adults 55-80 w/hx of smoking?

A

Once they have quit smoking for 15 years, (or if they develop a health problem which would likely kill them anyway or if they are unwilling to have curative lung surgery)

58
Q

How should we assess the risk of cancer?

A

Hereditary risk

w/need for genetic counselor or tumor markers

59
Q

What preventive factors should we address w/ patients regarding cancer?

A
  • Avoid tobacco
  • Be physically active
  • Keep good weight
  • Good diet
  • Limit ETOH
  • Prevent STI
  • Avoid excess UV exposure
60
Q

STI & Blood Born Infections (Chlamydia & Gonorrhea)
Screen sexually active women 24 y/o or younger OR older women at increased risk
What grade?

A

B

61
Q

STI & Blood Born Infections (Chlamydia & Gonorrhea)
Men
What grade?

A

I = insufficient evidence

62
Q

Hep B, people at high risk

What grade?

A

B

63
Q

Hep B, screen pregnant women at 1st prenatal visit.

What grade?

A

A

64
Q

Hep C, people at high risk

What grade?

A

B

65
Q

Hep C, adults born between 1945-1965 (baby boomers). What grade? How often?

A

B

offer 1 time screening

66
Q

Why is it that we screen women for Chlamydia & Gonorrhea, but not men?

A

Women are more asymptomatic, and if untreated can lead to PID –> infertility

67
Q

What ages should we screen for HIV?

A

15-65, or older/younger if they are at increased risk

68
Q

What grade for HIV screening in pregnant women?

A

A

69
Q

Syphilis screening for asymptomatic, non-pregnant adults, adolescents at increased risk.
What grade?

A

A

70
Q

Syphilis screening for pregnant women.
What grade?
When?

A

A

EARLY screening

71
Q

What grade & type of screening is recommended for sexually active adolescents/adults by the USPSTF?

A

Intensive behavioral counseling (bc/ at risk for STI)

Grade B

72
Q

What are the 3 psycho-social health concerns?

A
  • Depression
  • Substance issues
  • Intimate Partner Violence
73
Q

What 3 types of people should we screen for depression?

What grade?

A
  • Adults
  • Pregnant women
  • Postpartum women
74
Q

Depression, major depressive disorder in adolescents 12-18 y/o
What grade?

A

B

75
Q

Depression, children 11 y/o and younger.

What grade?

A

I = insufficient evidence

76
Q

Depression, perinatal

What grade?

A

In progress

77
Q

PHQ-9 & WHO-5 are screening tools for what disorder?

A

Depression

78
Q

Tobacco, adults (including pregnant women)

What grade?

A

A

79
Q

Tobacco, children/adolescents

What grade?

A

B

80
Q

Alcohol, adults 18+ (including pregnant women)

What grade?

A

B

81
Q

Alcohol, 12-17 y/o

What grade?

A

I = insufficient evidence

82
Q

Drug use, (adults, kids, pregnant women)

What grade?

A

I

83
Q

Drug use, kids not already diagnosed w/substance disorder

What grade?

A

I

84
Q

Intimate Partner Violence, women of reproductive age

What grade?

A

B

85
Q

Intimate Partner Violence, older or vulnerable adults

What grade?

A

I

86
Q

What are the 3 endocrine disorders?

A
  • Thyroid
  • Osteoporosis
  • Obesity
87
Q

Thyroid dysfunction.

What grade?

A

I

88
Q

Thyroid cancer.

What grade?

A

D

89
Q

Osteoporosis, women 65+
Screen w/ bone measurement
What grade?

A

B

90
Q

Osteoporosis, post-menopausal women under 65 who are at increased risk for osteoporosis.
What grade?

A

B

91
Q

Osteoporosis,
MEN
What grade?

A

I

other groups apart from USPSTF have screening for men

92
Q

Obesity, adults with BMI of 30 or more

What grade?

A

B (multicomponent behavioral interventions)

93
Q

Obesity, children/adolescents 6 y/o and over.

What grade?

A

B

94
Q

Vision, gluacoma.

What grade?

A

I

95
Q

Vision, adults 65+

What grade?

A

I

96
Q

Vision, children (at least once) ages 3-5

What grade?

A

B

97
Q

Hearing, asymptomatic adults age 50+

What grade?

A

I

98
Q

Injury prevention to prevent falls adults w/ exercise 65+

What grade?

A

B

99
Q

Injury prevention to prevent falls adults w/ multifactorial intervention 65+
What grade?

A

C

100
Q

Injury prevention to prevent falls adults w/ Vitamin D supplementation 65+
What grade?

A

D

101
Q

USPSTF recommendation for oral health.

What grade?

A

NONE, they say nothing about oral health.

102
Q

What does Electronic Preventive Services Selector (EPSS) do?

A

Used by providers (PCPs) to figure out what preventive service is appropriate for their patients.

Foundations Exam 3 COPY (4 decks)

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