Term
| what is primary prevention? |
|
Definition
| avoids the development of a disease |
|
|
Term
|
Definition
to evaluate the benefits of individual services based on age, gender, and risk factors for disease
make recommendations about which preventive services should be incorporated routinely into primary medical care and for which populations.
identify a research agenda for clinical preventive care. |
|
|
Term
| Describe the grading system USPSTF uses for recommendations? |
|
Definition
A = strongly recommends
B = recommended
C = no recommendation for or against
D = recommends against
I = insufficienct evidence to recommend for or against |
|
|
Term
| What setting are USPSTF recommendations intended to be used in? |
|
Definition
|
|
Term
| process of enabling peopel to increase control over ther health and its determinants, and thereby improve their health... |
|
Definition
|
|
Term
| who does health promotion focus on? |
|
Definition
|
|
Term
| what does health promotion focus on? |
|
Definition
| healthy public policy that addresses income, housing, food, security, employment, quality working conditions. |
|
|
Term
| How many levels of disease prevention are there and what are they? |
|
Definition
primary = avoids development of a disease.
secondary = activities are aimed at early disease detection
tertiary = reduces negative impact of an already established disease |
|
|
Term
| USPTF recommendations for colorectal cancer screening? |
|
Definition
A = screening using fecal occult blood testing, sigmoidoscopy, or colonoscopy from age 50-75.
C = recommends against screening from age 76-85.
D = recommends against screening in adults older than 85.
I = CT colonoscopy and fecal DNA testing |
|
|
Term
| greater than 80% of colorectal cancer arise from what? |
|
Definition
|
|
Term
| 90% of colorectal cancer occurs in people of what age? |
|
Definition
|
|
Term
| 3rd MC cancer in men and women in the US |
|
Definition
|
|
Term
| risk factors for colorectal cancer |
|
Definition
age > 50
personal hx of CRC
IBD
FHx
ethnic background
diet
physical inactivity
obesity
smoking
alcohol intake |
|
|
Term
| In terms of CRC, if FOBT is positive, what should be done? |
|
Definition
| a colonoscopy to confirm location of bleeding |
|
|
Term
| this test is done the same way as FOBT, but is more specific and reducs the number of false positive results. |
|
Definition
| Fecal immunochemical test |
|
|
Term
|
Definition
FIT is not affected by vitamins or foods.
Both still require confirmation. |
|
|
Term
| How far can a flex sig visualize compared to a colonoscopy |
|
Definition
flex sig = rectum and lower colon
colonscopy = allows visualization of the entire colon |
|
|
Term
| procedure that produces the best picture for the lining of the colon |
|
Definition
| double contrast barium enema |
|
|
Term
| 5 A's of tobacco counseling |
|
Definition
Ask about tobacco use
Advise to quit
Assess willingness
Assist
Arrange follow up |
|
|
Term
|
Definition
nicotine replacement: gum, patch, inhaler, nasal spray
wellbutrin
chantix |
|
|
Term
| USPTF oral cancer recommendations |
|
Definition
| I - screening adults for oral cancer |
|
|
Term
| risk factors for oral cancer |
|
Definition
tobacco use
alcohol + tobacco use |
|
|
Term
| 2 things to consider with oral cancer |
|
Definition
any lesions warrants cancer as a differential
refer any suspicious lesion to derm/ENT to be safe |
|
|
Term
| USPSTF recommendations for testicular cancer |
|
Definition
| D - recommends against routine screening of asx adolescents and adult males |
|
|
Term
| MC cancer between 20 and 34 yo |
|
Definition
|
|
Term
| 2nd MC cancer between 35 an 39 yo |
|
Definition
|
|
Term
| 3rd MC cancer between 15 and 19 yo |
|
Definition
|
|
Term
| testicular cancer look alikes (6) |
|
Definition
benign scrotal mass
epididymitis
hydrocele
spermatocele
varicocele
orchitis |
|
|
Term
| first step in dx of a testicular mass after identification |
|
Definition
| testicular ultasound - DO NOT biopsy |
|
|
Term
| cure rate for testicular cancer if caught early |
|
Definition
|
|
Term
| USPSTF recommendations for Hep B |
|
Definition
A = screen all pregnant women at their first prenatal visit.
D = routinely screening the general asx population |
|
|
Term
| at what ages is ASA a class A recommendation according to USPSTF for coronary heart disease (CHD) |
|
Definition
men = 45-79 yo
women = 55-79 yo |
|
|
Term
| when does the USPSTF recommend against the use of ASA for prevention |
|
Definition
women less than 55 for stroke
men less than 45 for MI |
|
|
Term
| decisions about ASA use should consider what 2 things? |
|
Definition
| overall risk for stroke/MI and risk of GI bleed. |
|
|
Term
| USPSTF recommendations for lung cancer |
|
Definition
| I = screening asx persons for lung cancer with either low dose computerized tomography (LDCT), chest x-ray (CXR), sputum cytology, or a combo of these tests |
|
|
Term
| this test is 4s more sensitive than CXR in detecting lung cancer |
|
Definition
| low dose computerized tomography (LDCT) |
|
|
Term
| USPSTF recommendations for lipid screening |
|
Definition
A = women age 45 and older with increased risk of CHD.
B = women age 20-35 with increased risk of CHD.
A = men age 35 and older with increased risk of CHD.
B = men age 20-35 with incraesed risk of CHD.
C = screening of men or women not at increased risk. |
|
|
Term
| disease processes that = incraesed risk for CHD |
|
Definition
diabetes
hx of CHD/atherosclerosis
FHx of CVD (< 50 in males, < 60 in females)
tobacco use
HTn
obesity (BMI > 30) |
|
|
Term
| screening tests for lipid disorders (3) |
|
Definition
total cholesterol
HDL-C (fasting)
calculated LDL |
|
|
Term
| appropriate initial therapy for most people with lipid disorders |
|
Definition
lifestyle mods (diet and exercise).
drug therapy is more effective than diet alone. |
|
|
Term
| occurs when the arteries that supply blood to the haert muscle become hardened and narrowed |
|
Definition
|
|
Term
|
Definition
angina
pain in the chest, shoulders, neck, jaw, or back.
heart attack
CHF
arrythmias |
|
|
Term
|
Definition
electrocardiogram (ECG)
exercise treadmill test (ETT)
electron-beam computerized tomography (EBCT) |
|
|
Term
| screening for CHD could potentially decrease CHD events in what 2 ways |
|
Definition
1. by detecting people at HIGH risk for CHD events who could benefit from more aggressive risk factor modification.
2. by detecting people with existing severe CAS whose life could be prolonged by CABG surgery |
|
|
Term
| what is important to remember about an negative test for CHD |
|
Definition
| it does NOT rule out the presence of coronary stenosis of vessels or future CHD event. |
|
|
Term
| USPSTF recommendations for AAA screening |
|
Definition
B - one time screening for men aged 65-75 who have smoked (ultrasound)
C - no recommendation for men age 65-75 who have not smoked. |
|
|
Term
| USPSTF recommendations for AAA screening |
|
Definition
B - one time screening for men aged 65-75 who have smoked (ultrasound)
C - no recommendation for men age 65-75 who have not smoked.
D - women |
|
|
Term
| what size AAA is a surgical candidate vs. periodic surveillance |
|
Definition
surgery = 5.5cm or greater
surveillance = 4.0 - 5.4cm |
|
|
Term
| median age of onset for menopause |
|
Definition
|
|
Term
| life expectancy after menopause |
|
Definition
|
|
Term
| hormone therapy is used for tx of what conditions in the menopausal and post-menopausal periods? (4) |
|
Definition
menopause sxs
osteoperosis
to decrease the risk of colon cancer
prevent memory/thinking problems |
|
|
Term
|
Definition
combo therapy (estrogen + progestin)
estrogen only (only women who had a hysterectomy) |
|
|
Term
|
Definition
does not decrease/possibly increases the risk of heart disease.
increases the risk of blood clots and stroke.
increases risk of gallbladder problems. |
|
|
Term
| USPSTF recommendations on HRT |
|
Definition
| D - against the use of both combo and unopposed estrogen for prevention of chronic conditions in postmenopausal women. |
|
|
Term
| USPSTF recommendations for chlamydial screening |
|
Definition
A - all sexually active women < 24 yo and all sexually active women at increased risk.
B - pregnant women < 24 yo and all pregnant women at incraesed risk.
B - all women age 24+ not pregnant and not at incrased risk.
I = screening men. |
|
|
Term
| MC reportble disease in the U.S. |
|
Definition
|
|
Term
|
Definition
azithromycin 1g PO
doxycycline 100mg PO BID x 7 days |
|
|
Term
| USPSTF recommendations for HSV screening |
|
Definition
D - routine serological screening for HSV in asx pregnant women
D - routine screening for HSV in asx adolescents and adults |
|
|
Term
| by adulthood what percent of the US population has antibodies for HSV 1? |
|
Definition
|
|
Term
| HSV 2 prevalence is highest in who? |
|
Definition
| women and non-hispanic blacks |
|
|
Term
| USPSTF recommendations for gonorrhea screening |
|
Definition
B - screen all sexually active women if they are at increased risk.
I = screening men at increased risk.
D - screening men and women at low risk.
I - pregnant women not at increased risk
A - prophylactic topical ocular meds for all newborns |
|
|
Term
|
Definition
3rd generation cephalosporin OR
flouroquinalone (except MSM, CA, HI, or Asia).
concurrently presumptively tx for chlamydia |
|
|
Term
| USPSTF recommendations for HIV screening |
|
Definition
A - all adolescents and adults at increased risk.
C - screening adolescents and adults not at incraesed risk.
A - screen all pregnant women
B - high intensity behavioral counseling to prevent STI for all sexually active adolescents and adults at increased risk. |
|
|
Term
| USPSTF recommendatiosn for syphilis screening |
|
Definition
A - screen all persons at increased risk.
D - asx persons not at increased risk.
A - all pregnant women |
|
|
Term
| risk factors for syphilis |
|
Definition
MSM
commercial sex workers
person who exchange sex for drugs
adult correctional facilities |
|
|
Term
| NTD prevention in women of childbearing age |
|
Definition
| folic acid supplementation |
|
|
Term
| MC reaction to immunizations |
|
Definition
redness and swelling at the injection site, fever, pain at injection site
(these are the ones listed at kidshealth.org) |
|
|
Term
| USPSTF recommendations for cervical cancer |
|
Definition
A - women who have been sexually active and have a cervix
D - women 65 + who have had adequate recent screening with normal pap smears and are not otherwise at increased risk.
D - routine Pap screening in women who have had a hysterectomy.
I - HPV testing as a primary screening test for cervical cancer. |
|
|
Term
| second MC cancer worldwide |
|
Definition
|
|
Term
| MC HPV strains to cause cancer |
|
Definition
|
|
Term
|
Definition
| surgery (early), chemo + radiation (advanced) |
|
|
Term
| goal of cytological evaluation of the cervix |
|
Definition
| to sample the transformation zone |
|
|
Term
| what takes place at the "transformation zone" |
|
Definition
columnar endocervical epithelium changes to squamous epithelium.
dysplasia and cancer may arise. |
|
|
Term
| what is used to sample the ectocervix vs. endoscervix? |
|
Definition
ectocervix = extended tip spatula
endocervis = cytobrush |
|
|
Term
| optical age for Pap Smear screening? |
|
Definition
| 3 years afer onset of sexual activity or age 21 whichever comes first. |
|
|
Term
| when to stop pap smear screening |
|
Definition
ACS recommends stopping at age 70 UNLESS:
older woman not previously screened.
info from previous screens unavailable.
screening unlikely to have occured in the past (foreign countries) |
|
|
Term
| who can safely stop pap smear screening? |
|
Definition
| women age 70 + who have had 3+ documented consecutive, technically satisfactory normal/negative cervical cytology tests and who have had no abnormal/positive cytology tests within the last 10 years can safely stop screening. |
|
|
Term
| how often are pap smears recommended? |
|
Definition
| yearly until 2 or 3 normals, then can switch to every 3 years. |
|
|
Term
| pap smear recommendations in regards to hysterectomy |
|
Definition
discontinue if hysterectomy was for benign reasons.
continue if reason for hysterectomy is unknown or if hysterectomy was due to invasive cervical cancer. |
|
|
Term
| majority of invasive cervical cancer occurs in who? |
|
Definition
| women who are not adequately screened. |
|
|
Term
| USPSTF recommendations for obesity |
|
Definition
| B = screen all adult pts for obesity and offer intensive counseling and behavioral interventions to promote sustained weight loss. |
|
|
Term
| most practical measure of obesity |
|
Definition
|
|
Term
|
Definition
overweight = 25 - 29.9
obese = 30 or above
class 1 obesity = 30 - 34.9
class 2 obesity = 35 - 39.9
class 3 obesity = 40+ |
|
|
Term
| most effective interventions for obesity |
|
Definition
| combination of nutrition education and diet with exercise counseling and behavioral strategies |
|
|
Term
|
Definition
|
|
Term
| USPSTF recommendations for osteoperosis |
|
Definition
| B = screen all women age 65 and older, and women at increased risk age 60 and older. |
|
|
Term
| single best predictor of low bone mineral density |
|
Definition
| lower body weight (less than 70kg) |
|
|
Term
| components of the Osteoperosis Risk Assessment Instrument (ORAI) |
|
Definition
low weight
no use of estrogen therapy
age |
|
|
Term
| best predictor of hip fracture |
|
Definition
| Dual-Energy x-ray absorptiometry (DEXA) |
|
|
Term
| pharmacotherapy for osteoperosis |
|
Definition
| HRT, bisphosphonates, SERMs |
|
|
Term
|
Definition
|
|
Term
| CDC recommends vaccination against what 13 diseases by 18 months? |
|
Definition
Hepatitis B
Rotavirus
diptheria
tetanus
pertussis
Haemophilus influenzae type B
pneumococcal disease
polio
measles
mumps
rubella
chickenpox
Hepatitis A |
|
|
Term
| 5 A's of behavioral counseling framework |
|
Definition
Assess
Advise
Agree
Assist
Arrange |
|
|
Term
| this causes more than 75% of all skin cancer deaths |
|
Definition
|
|
Term
| what two skin cancers are more comman than melanoma but cause less morbidity and mortality? |
|
Definition
| basal cell and squamous cell |
|
|
Term
| MC form of all skin cancer |
|
Definition
|
|
Term
| where does basal cell carcinoma occur most often? |
|
Definition
| face, ears, neck, shoulders, and back |
|
|
Term
| skin cancer with the most potential to metastasize |
|
Definition
|
|
Term
| USPSTF recommendations for skin cancer |
|
Definition
| I - for primary care providers counseling pts to prevent skin cancer. |
|
|
Term
| ACS, AAD, AAP, ACOG, and NIH recommendations on skin cancer |
|
Definition
| all recommend patient education concerning sun avoidance and sunscreen use. |
|
|
Term
| 3 most important environmental factors pertaining to pancreatic cancer |
|
Definition
| smoking, obesity, alcohol abuse |
|
|
Term
| MC type of pancreatic tumor |
|
Definition
| exocrine = adenocarcinoma, adenosquamous, squamous cell carcinoma, giant cell carcinoma |
|
|
Term
| 3 important steps to preventing pancreatic cancer |
|
Definition
avoid smoking
eat plenty of fruit, veggies, and whole grains.
Cut down on red meat, especially those that are highly processed. |
|
|
Term
| USPSTF recommendations for pancreatic cancer screening |
|
Definition
| D = against routine screening of asx adults using abd palpation, ultrasound, or serologic markers. |
|
|
Term
| USPSTF recommendations for screening high blood pressure |
|
Definition
| A = screenng all adults age 18 and older |
|
|
Term
|
Definition
normal < 120 / < 80
pre-HTN 120-139 / 80-89
stage 1 HTN 140-159 / 90-99
stage 2 HTN 160 - 179 / 100-109
stage 3 HTN >180 / >110 |
|
|
Term
| MC primary diagnosis in America |
|
Definition
|
|
Term
|
Definition
| African Americans and the elderly |
|
|
Term
| complications from HTN (7) |
|
Definition
| MI, stroke, heart failure, premature death, ESRD, retinopathy, aortic aneurysms |
|
|
Term
| JNC recommendations for BP screening |
|
Definition
| every 2 years for persons with SBP and DBP below 130/85 mm Hg and more frequent intervals for those with higher BP |
|
|
Term
| what should be considered in conjunction with the actual level of BP elevation when choosing a treatment plan? |
|
Definition
| overal cardiovascular risk = smoking, diabetes, abnormal blood lipids, age, sex, sedentary lifestyle, obesity |
|
|
Term
| most pts with HTN will require what to achieve their BP goal? |
|
Definition
|
|
Term
|
Definition
| thiazide diuretics, ACEI, ARB, BB, CCB |
|
|
Term
| non-pharmacotherapy tx for HTN |
|
Definition
reduce dietary sodium intake
potassium supplementatino
increased physical activity
weight loss
stress management
reducing alcohol intake |
|
|
Term
| most studied screening tool to detect alcohol related problems |
|
Definition
| Alcohol Use Disorders Identification Test (AUDIT) |
|
|
Term
| how is the AUDIT test divided up among consumption, dependence, and problems. |
|
Definition
questions 1-3 = consumption
questions 4-6 = dependence
questions 7-10 = alcohol related problems. |
|
|
Term
| what AUDIT score indicates a strong likelihood of hazardous or harmful alcohol consumption in men? women? |
|
Definition
men = 8 or more
women = 7 or more |
|
|
Term
| what AUDIT score is suggestive of dependence? |
|
Definition
|
|
Term
| what does CAGE stand for in regards to alcohol screening? |
|
Definition
C = cut down
A = annoyed at criticism
G = guilty feelinga bout drinking
E = eye opener in the morning |
|
|
Term
| what pneumonic is used to screen adolescents for alcohol misuse? |
|
Definition
|
|
Term
| what does CRAFFT stand for? |
|
Definition
C = car (have you ridden in a car with someone who was high or using alcohol/drugs)
R = relax (do you ever use alcohol or drugs to relax, feel better, fit in?)
A = alone (do you ever use alcohol or drugs while you are by yourself?)
F = Forget (do you ever forget things you did while using alcohol/drugs?)
F = family/friends (do your family or friends ever tell you taht you should cut down?)
T = trouble (ever gotten in trouble while using alcohol or drugs?) |
|
|
Term
| what pneumonics are used to screen pregnant women for misuse? why? |
|
Definition
TWEAK or T-ACE
because they detect lower levels of alcohol consumption that may cause risk in pregnancy. |
|
|
