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risk assessment Flashcards

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1
Q

How often does a 20 yo. F need to receive a clinical breast exam?

A

every 3 years

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2
Q

total cholesterol & HDL: when to start checking? how often to check?

A

start at 20

repeat every 5 years unless chol above 200 mg/dL

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3
Q

How do you manage high lipid panel results?

A

LDL: statin
HDL: changing lifestyle

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4
Q

When are mammography indicated and how often should they be repeated?

A

start at 40 and repeat every 2 - 3 years

from 40 - 74, repeat annually (or as long as in good health)

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5
Q

When is an EKG indicated during a health screening? How often should it be repeated?

A

at 40 to provide baseline

repeat every 2 years if cardiac risk factors present

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6
Q

How often should a male receive a fecal occult blood test to assess for colorectal cancer?

A

annually starting at age 50

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7
Q

When is it appropriate to discontinue PAP smear and cytology screening in women?

A

when older than 65 - 70

discontinue after 3 consecutive normal cytology tests and no abnormal tests in past 10 years

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8
Q

Women and men over 60 years old should have a complete physical exam how often?

A

Every 2 years

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9
Q

What is the leading cause of death of African-American M lt35 yo?

A

Homicide

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10
Q

pneumonia and influenza in elderly adults

A

top killer, often requires hospitalization in this population

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11
Q

Top 4 killers of adults in the United States

A
  1. heart disease (CAD)
  2. cancer
  3. lower respiratory disease (asthma, COPD)
  4. CVA
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12
Q

What syndrome is associated with cardioembolic events (CAD & CVA)?

A

metabolic syndrome

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13
Q

Which cancer has the highest mortality in both adult men and women in the United States?

A

LUNG

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14
Q

Leading GYN cancer mortality in women?

A

OVARIAN

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15
Q

How do you screen for ovarian cancer?

A

Siiiike! THERE IS NONE!

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16
Q

Other than skin cancer, cancer with highest incidence in women?

A

BREAST

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17
Q

What is the mortality rate associated with breast cancer in women?

A

Low. 95% survival rate.

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18
Q

What is the second most common cancer mortality in men?

A

PROSTATE

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19
Q

What is the second leading cancer mortality in men and women combined?

A

COLORECTAL

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20
Q

immunizations and vaccinations are an example of what kind of prevention?

A

primary

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21
Q

What is secondary prevention?

A

Early identification AND treatment of existing problems

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22
Q

pap smear is what kind of prevention?

A

Secondary

Screening = Secondary

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23
Q

Tertiary Prevention

A

Rehabilitation and restoration of health

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24
Q

Cardiac rehabilitation s/p acute MI is what kind of prevention?

A

Tertiary

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25
Skilled Nursing Facility is what kind of prevention?
Tertiary: restoration & rehabilitation of health.
26
Side effect of St. John's Wort
↑ risk of clotting
27
St. John's Wort is contraindicated in combination with?
SSRI - Serotonin Syndrome beware, SJW is often used for depression!
28
Which herbal therapies are associated with increased risk of bleeding?
G whiz, you're bleeding! Ginger Ginseng Garlic Gingko Bilboa
29
Which herbal therapy should be used cautiously in DM patients and why?
Evening Primrose (risk for hyperglycemia)
30
Which of the following is a contraindication to receiving the influenza vaccination? a. PCN allergy b. Being pregnant c. Being immunocompromised d. Allergic to eggs
D. Influenza is contraindicated in egg allergy
31
Can a pregnant woman receive an influenza vaccination?
Yes
32
When individuals are immunized with a vaccine, the type of immunity is called: a. natural immunity b. artificially acquired immunity c. passive immunity d. none of the above
B. artificially acquired immunity
33
Elevated homocystine levels are associated with: a. ARF b. PNA c. premature CAD d. GERD
C. thombosis and premature CAD cause elevated homocystine levels
34
Which of the following is an example of primary prevention: a. mammogram b. pneumococcal vaccine c. pap smear d. controlling HTN
b
35
What is the best way to detect breast cancer?
Mammogram
36
The leading cause of death in adolescents
MVC
37
CEA is most useful for the monitoring the activity of: a. breast cancer b. melanoma c. thyroid cancer d. colorectal cancer
Colorectal cancer
38
Screening is defined as:
detection of a disease process before occurrence of symptoms
39
Sensitivity of a test is defined as the:
Probability that a test will be positive if the disease is positive
40
Which of the following patients should be treated with a cholesterol-lowering agent? a. 40 M LDL cholesterol of 100 b. 55 yo. post-menopausal F with LDL 170 despite diet and exercise c. 60 M with HDL 35 d. 25 yo. M with family hx of CAD
B
41
How often should a 68 yo. F have a pap smear?
There is no need for her to have a PAP smear if the three previous tests were negative
42
Varicella is an example of what type of vaccine?
Attenuated vaccine
43
Pneumococcal vaccine contraindications
Hodgkins lymphoma active disease pregnancy
44
Which of the following vaccines are contraindicated during pregnancy: a. influenza b. varicella c. hep b d. none of the above
varicella (live)
45
In which age range can HPV vaccine series be given? | How is the series administered?
give between 10 - 25; three shot series Gardasil: 0, 2mo, 6 mo Cervarix: 0, 1mo, 6mo
46
How often is TDAP given?
every 10 years
47
pneumococcal vaccine: given to these 5 populations
``` smokers/asthmatics 19 - 64 immunocompromised chronic disease nursing home or LTCF 65+ ```
48
At what age should complete physicals occur, and how often should they be done?
20, every 5 - 6 years at age 60, every 2 years
49
At what age should conventional paps start and how often should they be repeated?
21, repeat every 3 years if no abnormalities
50
At what age should HPV co-test paps start and how often should they be repeated?
30, every 5 years if no abnormalities | no for women any younger!
51
At what age should clinical breast exams start? How often should they be repeated?
age 21 (same for self exams) and repeat every 3 years at age 40, switch to annually
52
How often should men perform self breast and testicular exams? At what age should they begin?
start at adolescence, perform monthly
53
BP: When to start monitoring, normal range, how often to repeat?
start at 20 normal 120/80 repeat with every visit or every 2 years
54
Zostavax should be given when? What is it for?
give at 50 once - for herpes zoster
55
What are the two prostate screening exams? At what age should they begin and how often should they be repeated?
digital rectal exam (DRE) & prostate surface antigen (PSA) - DRE & PSA should be done annually from 50 UNLESS: family hx of prostate cancer or black - perform annually from age 40
56
what are the three colorectal cancer screening tests? | at what age should colorectal cancer screening begin and how often should they be repeated?
begin screening at 50 - fecal occult blood test (FOBT): repeat annually - flexible sigmoidoscopy: repeat every 5 years - colonoscopy - - total colon exam: repeat every 10 years - - double contrast barium enema: repeat every 5 - 10 years
57
What is glaucoma screening and its normal range, when should it begin, how often should it be done?
tonometry (normal 10 - 20 mmHg) | begin at 40 - 59 and repeat annually
58
Ratio of adults who get shingles?
1 in 3
59
Pneumococcal vaccine should be given at what age?
65+ | 3x max per CDC
60
What kind of prevention are screening tests?
secondary | S = secondary = screening
61
incidence vs prevalence
FREQUENCY at which disease appears in population during specific time + RATE at which new cases occur during specific time VS PROPORTION of population affected by disease during specific time
62
What is the leading killer of black men and women under 40?
AIDS (HIV contracted in teens)
63
top 3 causes of death in young adults (20 - 39)
MVC homicide suicide
64
top 3 causes of death in middle aged adults (40 - 59)
heart disease accidents lung cancer
65
top 3 causes of death in elderly adults (60+)
heart disease CVA COPD
66
Other than skin cancer, what is the second most common cancer in men?
PROSTATE | it is also the second leading cancer mortality
67
Recommended intake of carbs, fats, protein?
carbs: 50 - 60% total calories fats: under 30% total calories + saturated fat under 10% total calories proteins: 0.8 - 1.0 g/kg/day
68
5 benefits of exercise
↓ LDL, stress, signs of aging | ↑ BMR, cardiovascular fitness
69
American Heart Association reccomendations for exercise x2
- exercise at least 30+ min most days of week | - target heart rate should be sustained for 30 minutes (improves conditioning)
70
35+ who have never exercised regularly should do what first? x3
complete history physical exam exercise stress test
71
typhoid immunization is what kind of immunity?
ACTIVE - ab stimulated with specific antigen
72
gamma globulin is what kind of immunity?
PASSIVE
73
maternal immunity transferred to fetus is what kind of immunity?
PASSIVE
74
vaccination is what kind of immunity?
ACTIVE ACQUIRED
75
comorbs warranting pneumococcal vaccine admin
- lung, heart, liver, kidney disease | - chronic diseases like DM, cirrhosis, sickle cell, alcoholism, etc
76
Consider Hep A vaccine if...
military, travel to endemic area, MSM
77
Consider Hep B vaccine if...
all health care workers, high risk pts (includes sexually active),
78
which hepatitis is a risk factor for fulminant liver failure?
Hep B
79
meningococcal vaccine is approved for what ages? recommended as routine for what ages? catch up for what ages?
approved for 2 - 55 routine for 11 - 12 catch up for college, military, immunecompromised, travellers to Africa
80
SJW may potentiate what important drug class?
NARCOTICS
81
herbal therapies used for lady problems
black cohosh | evening primrose
82
kava kava + alcohol
alcohol increases toxic effects!
83
evening primrose + DM
may elevate blood glucose so beware!

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