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Flashcards in risk assessment Deck (83):
1

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

every 3 years

2

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

start at 20
repeat every 5 years unless chol above 200 mg/dL

3

How do you manage high lipid panel results?

LDL: statin
HDL: changing lifestyle

4

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

start at 40 and repeat every 2 - 3 years
from 40 - 74, repeat annually (or as long as in good health)

5

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

at 40 to provide baseline
repeat every 2 years if cardiac risk factors present

6

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

annually starting at age 50

7

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

when older than 65 - 70
discontinue after 3 consecutive normal cytology tests and no abnormal tests in past 10 years

8

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

Every 2 years

9

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

Homicide

10

pneumonia and influenza in elderly adults

top killer, often requires hospitalization in this population

11

Top 4 killers of adults in the United States

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

12

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

metabolic syndrome

13

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

LUNG

14

Leading GYN cancer mortality in women?

OVARIAN

15

How do you screen for ovarian cancer?

Siiiike! THERE IS NONE!

16

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

BREAST

17

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

Low. 95% survival rate.

18

What is the second most common cancer mortality in men?

PROSTATE

19

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

COLORECTAL

20

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

primary

21

What is secondary prevention?

Early identification AND treatment of existing problems

22

pap smear is what kind of prevention?

Secondary

Screening = Secondary

23

Tertiary Prevention

Rehabilitation and restoration of health

24

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

Tertiary

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!