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Flashcards in Preventive medicine Deck (20):
1

HTN screening

USPSTF guideline:
screen adults for HTN
there is no particular interval

JNC7: check BP once at least every 2 years beginning at age 18

2

Cholesterol screening

Men- age 35
Women- age 45
Screen every 5 years

3

Smoking cessation

Counseling to quit at every encounter:
-ask, assess, advise, assist, arrange
-set a precise quit date while in clinic- instruct patient to throw away all smoking paraphernalia including ash trays and lighters
-offer American Cancer Society quitline: 1-800-ACS-235
-Offer prescription therapies to help them quit

Nicotine replacement doubles the quit rate
-much higher efficacy when used with buproprion
-available as patch, gum, inhaler, nasal spray, lozenge

Prescription therapies help people quit smoking
-Varenicline: side effects include nausea, suicidal thoughts, bizarre dreams
-Buproprion, more effective if used with nicotine replacementl side effects include dry mouth, weight loss, contrasindications include seizure disorder, pregnancy, eating disorders

4

Preventive medicine for ages 50-65

History and counseling:
-ask about smoking and alcohol use
-remind about exercise, high fiber, sunscreen (SPF15), seat belts, high-risk behavior
-ask about depression, assault/abuse, advance directive/will
-dental exam/cleaning q6 months- 1 year
-daily MVI, calcium 1200 mg/day, and vitamin D > 600 IU/day
-flu shot annually
-tetanus-diphtheria booster (Td or Tdap) q 10 years. Use Tdap instead of Td if no previous Tdap
-Zostavax once after age 60, regardless of shingles history
-Consider ASA 81mg qD (to help prevent MI, stroke, colon CA)
*proven benefit if 10 year MI risk is >10%, or annual MI risk is >1%
*women who take ASA had a 25% decrease in deaths from all causes

Labs/studies:
-FOBT q1yr
-Colonoscopy q10yrs or flex sig/BE q3-5 years
-TSH q5yrs
-consider glaucoma screening q1-5 years (esp blacks)
-consider EKG q5yrs
-consider regular chem14, UA, and CBC (q1-5 yrs)
-Consider regular Chem 14, US, and CBC (q1-5 yrs)
-HIV test (ages 15-65; no frequency given)

5

WOmen>50yo

mammogram
USPSTF-every 2 years
other organizations recommend annual screening

no cut-off

6

increased RBC fragility

Vitamin E deficiency

7

Dermatitis, cheilosis, glossitis

Vitamin B2, B3, B9-folate, B12 deficiency

8

peripheral neuropathy, angular cheilosis, glossitis

Vitamin B12 deficiency

9

Hemorrhagic disease

Vitamin K deficiency

10

NTD

B9 (folate) deficiency

11

Dermatitis, diarrhea, dementia

niacin (B3) deficiency

12

megaloblastic anemia

B12, folate (B9) deficiency

13

Pernicious anemia

B12 deficiency

14

Bitot's spots, keratomalaxia, xerophthalmia

VitA deficiency

15

Osteomalacia

vit D deficiency

16

rickets

vit D deficiency

17

When to start screening for high cholesterol in otherwise healthy patients

men-age 35
women- age 45

18

when to start screening for HTN in normotensive patient

every 2 years, starting at age 18

19

which smoking cessation med has a side effect of suicidality?

Varenicline

20

what topical vitamins can treat psoriasis?

topical vit D analogs
vitamin A