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STEP 2 Biostats and epidemiology > Cancer/adolescent screen, prevention > Flashcards

Cancer/adolescent screen, prevention Flashcards

1
Q

Ideal screening program. disease characteristics? 4

A

common
serious
LONG ASYMPTOMATIC PHASE
CORRECTABLE if identified early

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2
Q

Ideal screening program. patient characteristics? 2

A

HIGH PREVALENCE in screened population
Appropriate age range and gender

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3
Q

Ideal screening program. test characteristics? 3

A

LOW COST relative to disease severity

High sensitivity and specificity

ACCEPTABLE to broad range of patients

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4
Q

Ideal screening program. program characteristics? 4

A

Identifies population to be screened

Avoids ,,overdiagnosis” (detects benign/indolent disease)

Avoids ,,lead-time” bias (detects disease early but does not alter ultimate prognosis)

IMPROVES OUTCOMES of screened vs nonscreened population

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5
Q

Primary prevention prevents what?

A

prevent the onset of disease

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6
Q

Primary prevention aim?

A

Aim is to reduce exposure

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7
Q

Primary prevention examples to reduce exposure?

A

For example:
* Weight loss, smoking, alcohol, eating better.
* Vaccination.

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8
Q

Secondary prevention ,,prevents” what?

A

early detection to delay progression

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9
Q

Secondary prevention screening tests what are?

A

Screening tests with high sensitivity.

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10
Q

Secondary prevention: positive screening tests?

A

If positive –> intervene with lifestyle and medications.

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11
Q

Tertiary prevention prevents what?

A

preventing complications.

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12
Q

Tertiary prevention. ka darom sitoj prevencijoj?

A

Treatment of disease; lifestyle modifications and drugs.

More responsive than preventive.

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13
Q

Cancer screening. Colon: Age to start? 2

A

a) 50
b) 10 year before diagnosis of a parent

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14
Q

Cancer screening. Colon. How to do? 3

A

FKS every 10 year
OR
Flexible sigmoidoscopy every 5 year + FOBT every 3 years
OR
FOBT every year

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15
Q

Cancer screening. Colon. at what age to stop?

A

75

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16
Q

Cancer screening. Breast. age to start?

A

50

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17
Q

Cancer screening. Breast. how to screen?

A

mammography every 2 years

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18
Q

Cancer screening. Breast. age to stop?

A

75 years of age

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19
Q

Cancer screening. cervical. age to start?

A

21

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20
Q

Cancer screening. cervical. how to screen? 2

A

PAP every 3 years
OR
PAP every 5 + HPV testing every 5 years

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21
Q

Cancer screening. cervical. age to stop? 2

A

65 years of age + 3 consecutive normal PAP

Total abdominal hysterectomy

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22
Q

Cancer screening. lung. age to start?

A

55-80 yo + >= 30 pack years + quit smoking < 15 year

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23
Q

Cancer screening. lung. how to screen?

A

low dose CT every year

24
Q

Cancer screening. lung. when to stop? 2

A

80 yo

quit smoking > 15 years

25
Q

Cancers which you do not screen for? 3

A
  1. PROSTATE CANCER
  2. OVARIAN CANCER
  3. ENDOMETRIAL CANCER
26
Q

Cancers which you do not screen. why not prostate?

A

Because of lead time bias, screening for it is useless

27
Q

Cancers which you do not screen. in what exception ovarian?

A

a. Normally we do not screen for it
b. However, screening should be done if the patient is BRCA positive

28
Q

US preventive service task force rec. for breast cancers screening.
Definitely beneficial: recommended?

A

mammogram every 2 years for women 50-74

29
Q

US preventive service task force rec. for breast cancers screening.
Possibly beneficial: individualize?

A

mammogram in women 40-49

30
Q

US preventive service task force rec. for breast cancers screening.
Uncertain benefit?

A

mammogram in women >= 75 y/o.

31
Q

Screen medical condition. abdominal aneurysm. WHO?

A

Male + >=65y + ever smoked in their lifetime

32
Q

Screen medical condition. abdominal aneurysm. how?

A

1-time abdomen UG

CT scan of abdomen done for some other condition

33
Q

Screen medical condition. osteoporosis. who?

A

Female + >=65

34
Q

Screen medical condition. osteoporosis. how?

A

DEXA scan (start bisphosphonates if positive)

35
Q

Screen medical condition. HCV. who?

A

baby boomers (1945-1965)

36
Q

Screen medical condition. HCV. how?

A

HC antibodies

37
Q

Screen medical condition. HIV. who?

A

everyone once OR anyone who ask for it

38
Q

Screen medical condition. HIV. how?

A

elisa

39
Q

Screen medical condition. HTN. who?

A

everyone at every visit

40
Q

Screen medical condition. HTN. how?

A

ambulatory monitoring

41
Q

Screen medical condition. DM. who?

A

hypertensive patients

42
Q

Screen medical condition. DM. how?

A

HbA1c

43
Q

Screen medical condition. hyperlipidemic disease. who? 3

A

Male >= 35
female >=45
Anyone >=20 with risk factors for CAD

44
Q

Screen medical condition. hyperlipidemic disease. how?

A

lipid panel

45
Q

Screen medical condition. depression. who?

A

geriatric

46
Q

Screen medical condition. depression. how?

A

PHQ-9

47
Q

Screen medical condition. mobility. who?

A

geriatric

48
Q

Screen medical condition. mobility. how?

A

Get up and go

49
Q

Routine adolescent screening. how often?

A

annually, unless otherwise indicated

50
Q

Routine adolescent screening. mental health. method?

A

Validated depression questionnaire

51
Q

Routine adolescent screening. sexual health. 3 methods?

A

Confidential discussion about sexual activity

Gonorrhea and chlamydia testing if sexually active

HIV testing (once at age <18)

52
Q

Routine adolescent screening. substance use? 1

A

confidential discussion about exposure use, abuse

53
Q

Routine adolescent screening. dyslipidemia? 1

A

lipid panel once between age 17 and 21

54
Q

Routine adolescent screening. safety 2

A

Inquiry about bullying
Inquiry about seabelt and helmet use

55
Q

Routine adolescent screening. MCC of death?

A

suicide –> screen for depression

56
Q

Routine adolescent screening. how depression can present?

A

o Depression can present as irritability, failure to gain an expected
amount of weight, and academic decline. Also, abdominal pain
and headache.

57
Q

Routine adolescent screening. screen depression, age?

A

All teenagers above the age of 12 should be screened.

STEP 2 Biostats and epidemiology (12 decks)

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