Approach to Basic Prevention

Question 1

Actions aimed at eradicating, eliminating, or minimizing the impact of disease and disability

Answer 1

Prevention

Question 2

The concept of prevention is best defined in the context of levels, traditionally called

Answer 2

Primary, secondary, and tertiary prevention

Question 3

Prevention before exposure, i.e. sanitation, nutrition, immunization,and education

Answer 3

Primary Prevention

Question 4

Prevention after exposure, i.e. early detection (screening), and early intervention

Answer 4

Secondary prevention

Question 5

Prevention after the disease process, i.e. reversing the course of disease, rehabilitation, and treatment

Answer 5

Tertiary Prevention

Question 6

A classic example of primary prevention is

Answer 6

Immunizations

Question 7

New Jersey requires that children be vaccinated to attend

Answer 7

School or daycare

Question 8

State vaccine requirements do allow

Answer 8

Religious or medical exemption

Question 9

A general philosophical or moral objection to the vaccination is not sufficient for an exemption on

Answer 9

Religious grounds

Question 10

During the existence of an emergency, immunization exceptions can be suspended by the

Answer 10

State commissioner of Health

Question 11

What are four routine immunizations for adults?

Answer 11

1. ) DTap (Diptheria, Tetanus, acellular Pertussis)
2. ) Polio (IPV)
3. ) MMR
4. ) Varicella

Question 12

Early detection sounds good in theory, but we need to make sure that the tests are

Answer 12

Valid

Question 13

What are the criteria for screening tests?

Answer 13

Characteristics of the:

1. ) Disease
2. ) Population
3. ) Test

Question 14

What is a classic example of secondary prevention?

Answer 14

Screening Tests

Question 15

Significant morbidity and/or mortality, prolonged asymptomatic phase, and whether or not there are effective treatments available are all examples of characteristics of the

Answer 15

Disease

Question 16

The prevalence of the disease, the acceptance of screening tests, and the ability to comply/report are examples of characteristics of the

Answer 16

Population

Question 17

Incidence conveys information about the risk of contracting the disease, where as prevalence indicates

Answer 17

How widespread the disease is

Question 18

The sensitivity and specificity, the validity and reliability, and the cost effectiveness are characteristics of the

Answer 18

Test

Question 19

We need to make sure that our screening test fits the

Answer 19

Population

Question 20

The idea that if you discover a disease early in its course the patient will live longer by virtue of knowing the diagnosis, EVEN if the intervention had no effect

Answer 20

Lead-time bias

Question 21

Bias in screening tests cause by the fact that slower growing tumors that are less likely to kill are more likely to be detected by one time or periodic/interval screening

Answer 21

Length-time bias

Question 22

A bias in the statistics of screening tests, caused by the fact that persons who participate in screening are MORE LIKELY to engage in healthy activities, hence they are likely to live longer

Answer 22

Compliance/Adherence bias

Question 23

One problem with length time bias is that slow growing cancers may never

Answer 23

Kill

Question 24

What are the controversies associated with Mammography?

Answer 24

1. ) When (age) should we start screening
2. ) When (age) should we stop screening?
3. ) Is it ever cost effective?

Question 25

Reports yearly to congress about the critical evidence gaps in research related to clinical preventive services and recommends priority areas that deserve further examination

Answer 25

US Preventative Services Task Force (USPSTF)

Question 26

A main component of tertiary prevention is

Answer 26

Choosing Wisely

Question 27

Interventions to improve health care quality and reduce harm

Answer 27

Choosing Wisely

Question 28

Choosing wisely says that the measles and mumps vaccines have negligible egg protein; thus MMR can be given to

Answer 28

People allergic to eggs

Question 29

Choosing wisely suggest not screening for carotid artery stenosis in

Answer 29

Asymptomatic adult patients

Question 30

Says that the presence of bruit alone does not warrant serial duplex ultrasounds in low-risk, asymptomatic patients

Answer 30

Choose Wisely

Question 31

Choosing wisely says that performing routine admission or preoperative chest x-rays is not recommended for

Answer 31

Ambulatory Patients

Question 32

Choosing wisely says that the use of topical antibiotics on clean surgical wounds does NOT reduce the rate of infection compared to the use of

Answer 32

Non-antibiotic ointment or no ointment

Question 33

Usually indicated but doesn’t always save money

Answer 33

Primary prevention

Question 34

Screening must answer questions such as

Answer 34

Is the condition prevalent?
Does it have a prolonged asymptomatic phase?
Is it treatable early (i.e. does screening even matter)?

Question 35

Pay attention to who is making the recommendations and how they came up with their

Answer 35

Conclusions

Question 36

Not all tertiary interventions are

Answer 36

Indicated

Question 37

Don’t do a test for

Answer 37

“baseline” purposes

Question 38

Prevent the disease through education and immunizations

Answer 38

Primary prevention

Question 39

Screening for disease early and reducing the impact of the disease

Answer 39

Secondary Prevention

Question 40

Treating the disease and supporting people with the disease

Answer 40

Tertiary prevention

Question 41

Making sure not to repeat tests

Answer 41

Quaternary prevention

Question 42

Broad steps to prevent disease (Not individual preventions)

Answer 42

Primordial prevention