ACR 1 (Screening/Vaccination/Wellness visits) Flashcards
Screening test are performed to ID (symptomatic/asymptomatic) dz
asymptomatic
Criteria for screening include characteristic of the ___, ___, and ____
Disease Test Population screened
What characteristic of disease are criteria for screening? (5)
- Impacts quality/length of life - Prevalence vs Cost - There are acceptable methods of tx - There is an asymptomatic period - Can treat in the asymptomatic period
Characteristics of testing that are important for screening
The tests are specific and sensitive
Characteristic of the population that count as criteria for screening
- High dz prevalence - Accessibility - Compliance
_____ occurs when a dz that would have gone undiagnosed during a pt’s lifetime is dx because of a screening test
Over-diagnosis
5-A’s of Behavioral counseling?
- Ask - Advise - Assess willingness - Assist - Arrange f/u
What does CAGE stand for and what is it used for?
- Cut down? - Annoyed by criticizing - Guilt - Eye opener Questionnaire to assess alcohol abuse
What systems should be included in the ROS and PE for wellness exams
ALL of them
What are the 5 immunization categories
- Routine vaccinations of childhood/adolescence - Routine vaccinations of adults - Post exposure prophylactic - Travel related - Work-related/special circumstances
What are the 2 immunization types?
Active Passive
The following describes what type of immunization? - Contains live attenuated microorganisms, killed organisms, purified proteins or polysaccharides, or deactivated toxins - Provides long-term protection - Immunity is not achieved until 2-4 wks post injxn
Active
The following describes what type of immunization? - Performed antibody (immunoglobulin) - Immediate protection, but is shorter term of protection
Passive
What are the 7 vaccines that we should be familiar with?
influenza pneumococcal herpes zoster meningococcal tetanus HPV varicella
Then is the Influenza vaccine indicated?
all adults, every year
Then is the Pneumococcal vaccine indicated?
>65 y.o. Or ↑risk
Then is the Herpes zoster vaccine indicated?
adults >60 y.o. (contraindicated: preg, immunocomp)
Then is the Meningococcal vaccine indicated?
college, military, immunocompromised
Then is the Tetanus vaccine indicated?
10yrs, pregnant (27-36wks) one Tdap
Then is the HPV vaccine indicated?
Females to 26y.o. & males to 21
Then is the Varicella vaccine indicated?
Immunity
Adults can receive up to __ vaccines in 1 day in the ___
Adults can receive up to 4() vaccines in 1 day in the (deltoid)
If >1 live attenuated viral vaccine is indicated, administer them on the same day or at least __(time) apart
4 weeks
Immunoglobulin preparations + live viral vaccines (should/should not) be administered together as the Ig carries antibodies against such viruses
Immunoglobulin preparations + live viral vaccines (should NOT) be administered together as the Ig carries antibodies against such viruses
Live viral vaccine should be administered at least __ (time) prior to Ig prep.
2 wks
If Ig prep is given 1st, __ (time) should elapse before live viral vaccine can be given
3-11 months
Ig + non-living vaccines (can/cannot) be given together
Ig + non-living vaccines (CAN) be given together
Generally live-attenuated viral vaccines (should/should not) be administered to pregnant women & immunocompromised
Generally live-attenuated viral vaccines (SHOULD NOT) be administered to pregnant women & immunocompromised
What population should be screened for lung cancer?
What are the recommendations for the screen?
When should lung CA screening be discontinued?
55-80 y/o w/ a History of Smoking
Annual Screening if; ≥ 30 pack-year smoking hx, currently smoking or have quit w/in the past 15 yrs, and who are in relatively good health.
- Have not smoked for 15 yrs - Develops a health problem that substantially limits life expectancy or ability/willingness to have curative lung surgery.
What population should be screened for COPD
For who is COPD screening not recommended?
Asymptomatic adults
THE FUCK?
asymptomatic adults.
What population should be screened for Osteoporosis
What are other recommendations for Osteoporosis screening
Women, 65 y/o +
Recommended in Younger women whose fx risk is =/> a 65-year-old w/ no additional risk factors.
What population should be screened for Prostate CA?
Age 50 : average risk of prostate cancer and expected to live at least >10 years.
Age 45: high risk, includes; AAs, 1st-degree relative dx w/ prostate cancer at an early age (<65y/o).
Age 40 : higher risk (>1 first-degree relative who had prostate cancer at an early age).
What population should be screened for Breast CA?
What population can discontinue Breast CA screening
40-44 : should have the choice to start annual breast cancer screening if they wish to do so.
45-54 : should get mammograms every year.
55+ : mammograms every 2 years, or can continue yearly screening.
Screening should continue as long as a woman is in good health and expected to live >10 yrs
>75 y.o. and women w/ dense breasts can d/c screening
What population should be screened for Cervical CA?
When can Cervical CA screening be d/c
Age 21-65 y/o: every 3 years
Women >65 w/ adequate prior screening Women who have had a hysterectomy
What population should be screened for Colon CA?
How often should Colon CA screenings be performed?
When are colon CA not recommended?
50-75 y.o.
African Americans begin screening at 40-45 y/o
- Repeat e. 10 yrs in average-risk pts
- PMHx of colon polyps, e. 5 yrs
- Pt w/ 1st-degree family member who has had CRC, screening should start at 50 y/o, or 10 yrs before age of dx, whichever is younger and repeated e. 5 yrs
Not recommended: >85 y/o
What population is eligible for ASA therapy
50-59 y.o. - highest benefit from tx with low dose (81mg) is ASCVD is >10%
60-69 y.o. - likely to benefit if ASCVD is >10%
What populations are eligible to take Statins?

What population should be screened for DM?
45 y/o, ↑BP over-wt
Who gets screening for; HTN, obesity, smoking, alcohol, depression
Everyone gets screened e. visit
an infant should be Crawling around __ months
9 months
A child hsould be Walking by __ months
16 months
A child should be Talking by age __ and have a vocabulary of __ words
2 years
20 words