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(OMS1) PCM II Final > Approach to Health Maintenance & Counseling > Flashcards

Approach to Health Maintenance & Counseling Flashcards

1
Q

What is included in a history when a pt comes in for a well visit?

A

get a thorough history (PMH, PSH, meds, allergies)
include FEDTACOS (w/ extensive SH & FH, sex history)
evaluate risk factors based on lifestyle/family history

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2
Q

What are USPSTF recommendations?

A

recommendations of clinical preventive services put together by independent panel of experts who volunteer to help make evidence based recommendations

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3
Q

To who do recommendations apply?

A

to people who do not have signs or symptoms of the specific disease/medical condition

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4
Q

What is the gold standard for evidence based medicine?

A

systematic reviews (take different trials for stat analysis to use for larger population)

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5
Q

What is the purpose of EBM?

A

allows pts to have best outcomes b/c provides pts w/ most effective care based on best evidence

helps physicians use good evidence thru published data of outcomes

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6
Q

What are the 4 categories of preventive services?

A

screening
immunizations
general health guidance
counseling to reduce risk

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7
Q

Primary prevention

A

intervention to prevent disease

vaccines, diet counseling, tobacco counseling

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8
Q

Secondary prevention

A

screening test for disease early while pt may still be asymptomatic or before onset of disease

BP checks, labs, mammogram

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9
Q

Tertiary prevention

A

clinical intervention that prevents disease progression or reduce complications assoc w/ disease

medications for HTN/DM, chemotherapy, diet & counseling still beneficial

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10
Q

What are the highest priority of USPSTF guidelines?

A

grades A & B (what always want to follow & offer/provide service)

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11
Q

What is an example of a grade C service?

A

prostate screening if increased risk

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12
Q

When is distinction in prevention techniques blurred?

A

can counsel to avoid disease & also prevent complications associated w/ a disease

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13
Q

What is the purpose of a well visit?

A

used to treat current medical conditions & provide appropriate preventive care in effort to decrease health deterioration in future

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14
Q

What do you base prevention services on?

A

age
gender
risk factor (if entire general pop is @ risk)

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15
Q

What are some harms of screening that should be considered?

A

cost to pt

anxiety (will screen test cause pt more anxiety)

decrease benefit as pt ages or if pt has other comorbid conditions

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16
Q

What are clinical rules of thumb for checkups?

A

every 3 years for <49yo adults w/o chronic issues

every 1 year for >50yo w/o chronic issues (yearly labs)

17
Q

What are best practices for checkups for pts w/ chronic medical problems?

A

need follows up based on disease

pts w/ diabetes need A1C every 3 months to monitor & adjust meds

pts w/ HTN need followup every 3-6months depending on control to monitory for BP control

18
Q

General rules for cancer screenings in female

A 
Colon cancer (ages 50-75)
Lung Cancer (CT from 55-74yo if 30yr pack history)
Cervical cancer (pap smear from 21-65yo)
Breast Cancer (mammogram from 50-60yo)
19
Q

General rules for cancer screenings in males

A 
Colon cancer (ages 50-75)
Lung cancer (CT for ages 55-74 w/ at least 30 pack year history of smoking)
20
Q

General rule for CVS risk assessment

A

history is essential for screening

pts aged>20yo should undergo CVS risk assessment every 3 to 5 years (more frequently if pt has risk factors)

21
Q

What do you screen for in CVS risk assessment?

A 
diet
smoking
physical activity
HTN
dsyplipidemia
DM
obesity
22
Q

Immunization guidelines for adults

A 
flu vax for everyone
Td/Tdap every 10 yrs
HPV up to age 26
Zoster vax for >50yo
Pneumococcal vax for all >65yo
Hep B vax for all >65yo &amp; w/ diabetes (&amp; if @ increases risk)
23
Q

What is important to counseling?

A

motivational interviewing to see if patient is ready to change

24
Q

What are important parts of MI?

A

Open questions
Affirmations
Reflections (so pt knows you are listening)
Summaries

25
Q

What does counseling on tobacco use show?

A

counseling on tobacco use has shown dose response in pts (change in behavior w/ counseling & therapy)

26
Q

What is important in nutrition & exercise counseling?

A

take inventory of nutrition & exercise/activity

discuss what patient is willing & able to do-start w/ small changes w/ short term goals for each visit

27
Q

How do small steps in counseling help pt?

A

small steps for a longer time will most likely lead to bigger impact on pt’s behavioral change

(OMS1) PCM II Final (9 decks)

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