Screening Flashcards
(11 cards)
Describe screening tests metrics?
Understanding screening is an important concept in general medicine and is likely to be tested on all levels. A good screening test must be easy to perform and interpret. It needs to be applicable to the population at large and cannot be restricted to highly trained and specialized practitioners or centers. It must be accurate, reliable, and have a high sensitivity and specificity as high rates of false-positive or false-negative results will impact the overall performance of the test and may make it economically impractical if there are accelerated healthcare costs associated with chasing down false positive or negative test results
What is the screening recommendation for AAA?
A Grade 1A recommendation exists to screen all men aged 65-75 who have ever smoked for abdominal aortic aneurysm (AAA) with ultrasound
Cholesterol screening recommendations?
Every 5 years for:- all men 35 and older - men and women 20 and over with increased risk of heart disease with a Lipid panel
Blood pressure screening recommendations?
Every adult 18 and over, no interval specified via standard BP cuff
HIV screening?
5th generation test to everyone 15-65 at least once, younger if risk factors
All pregnant women
Colon cancer screening?
Everyone over the age of (45 is grade B and 50 is grade A), interval depends on testing method, none are better than another though colonoscopy is recommended strongly
Colonoscopy
Sigmoidoscopy
FOBT
Genetic Testing
Breast Cancer screening?
Women 50-74 every 2 years USPSTF in general
Cervical Cancer screening?
Pap smear starting in women age 21 every 3 years, at age 30 can add HPV testing, if negative, can extend the window to every 5 years until 65
Triple A surgical management guidelines?
In patients with an asymptomatic AAA, indications for surgical repair include a diameter ≥5.5 cm, rapid expansion, or a AAA associated with a peripheral arterial aneurysm or symptomatic peripheral artery disease which requires revascularization.
An abdominal aortic aneurysm (AAA) is diagnosed when the aortic diameter exceeds 3.0 cm. The surgical management of AAAs is evolving to become more personalized rather than to follow specific guidelines. Tests have often used the cutoff of 5.5cm as the guideline for elective surgical repair of AAAs as previous studies showed no improvement in mortality with surgical repairs of smaller aneurysms. Though this is often the case on tests, the actual management of AAAs is highly complex and must take into account not only the size and speed of the enlarging aneurysm but the patient’s own personal surgical risks. If the patient is a high surgical risk, then repair would not be performed until higher diameter aneurysms as the risks would outweigh the benefits at lower sizes. Conversely, if the patient is young, healthy, and at low surgical risk then perhaps early repair of a 4-5 cm aneurysm may make sense.
How to use the CAGE questions?
The CAGE questionnaire is a standard tool for assessing alcohol dependence in patients. CAGE stands for:
Have you ever felt you should Cut down on your drinking?
Have people Annoyed you by criticizing your drinking?
Have you ever felt bad or Guilty about your drinking?
Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover (Eye opener)?
Each question that is answered as a yes is 1 point. A score of 1 indicates the patient is at risk for alcohol dependence. A score of 2 to 3 points is highly suggestive of alcohol dependency. A score of 4 points is diagnostic for alcohol dependency.
What are primary, secondary, and tertiary prevention? examples?
Primary Disease not yet present Asymptomatic Prevent disease occurence Vaccination, dietary changes, not using tobacco products
Secondary Precursor present Asymptomatic Prevent morbidity from disease All cancer screening is considered secondary prevention; for example, skin cancer screening, mammogram, pap smear, and colonoscopy are all forms of secondary prevention
Tertiary Present Symptomatic Improve morbidity from disease Beta-blockers to prevent remodeling post-myocardial infarction, chemotherapy to prevent cancer recurrence, rehabilitation
