Return of the clinical Flashcards
(14 cards)
What does a grade C recommendation from the USPSTF mean?
Recommend selectively offering or providing the service based on patient preferences and professional judgement; benefit is small.
USPSTF screening recommendations for breast cancer are what?
start age 50-74 and mammogram every 2 years
When do you do osteoporosis screening according to the USPSTF?
age 65 and older or at risk
Name some well known grade D recommendations from the USPSTF
self breast exam cervical cancer screening under 21 HPV under 30 PSA screening Screening UA non pregnant persons and much much more
what are some differences in illness behavior that are unique to the elderly and make treatment especially tricky?
delayed or altered disease presentation
concurrent pathology
different trajectories of recovery
How does aziz ansari help me to remember the psychosocial aspects of aging that affect clinical outcomes?
gender, race, hx (military), kids/relationships, caregivers, elder mistreatment.
How do you determine the value of an elderly persons social relationships?
Size, type of support (financial, emotional), source (close friends, family, caregiver), frequency, quality
what are some benefits to spirituality in terms of mental and physical well being?
reduced anxiety and depression, substance abuse and quicker recovery from mental illness
Asking the elderly about ETOH and tobacco, you better get in the CAGE
cut down
annoyed
guilty feelings
eye opener
Grade I or no idea for USPSTF that may be on the test
dementia screening, thyroid, osteoporosis, hearing and vision,
OR Betty White saying crazy shit because she can’t see or hear and some due breaks her legs with a bat, and punches her in the neck. INTENSE
what sort of physical activity do you recommend for elderly persons to help with fall risk and for overall health? What type of prevention is this?
strength training, balance, stretching, aerobic
PRIMARY prevention
List the super 8 in tertiary prevention for the elderly and the associated clinically relevant garbage
functional assessment-ADL, IADL, frail scale
cognitive assessment-target patients with memory complaints: MME, Clock, Mini-Cog
depression-GDS
vision-eye exams, glaucoma
hearing-whisper test, finger rub
nutrition- screen FTT
incontinence
falls/mobility-inquire about recent falls, eval risk factors. Falls can be fatal-internal hemorrhage, DVT and PE from fracture.
Risk factors-guy: impaired vision, cognition, posture, Rx, ETOH, environment poor lighting, stairs, cat, rug, spill
You have a 65 y/o woman living at home come in for a yearly check up. She is it good physical shape and you’re wondering if you need to do a risk assessment for fall risk.
No unless she is at increased risk this is a grade C recommendation which moves to B with risk factors.
How old is too old to drive?
discuss with patients diagnosed with dementia, with family if permitted, may have to do a formal assessment.
