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AANP certification exam > chp 4 Health Screening and Promotion > Flashcards

chp 4 Health Screening and Promotion Flashcards

1
Q 
Mortality statistics:
Leading causes of death in all ages/genders is 
1 \_\_\_\_\_\_\_\_\_\_
2 \_\_\_\_\_\_\_\_\_\_
3 \_\_\_\_\_\_\_\_\_\_
A
  1. heart disease
  2. cancer
  3. Chronic lower resp diseases such as COPD
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2
Q

Cancer mortality:
Leading cause of cancer death:
_________ cancer

A

lung

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3
Q

Leading causes of cancer deaths in men:

  1. ________
  2. ________
  3. _______
A
  1. Lung
  2. prostate
  3. colorectal
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4
Q

Leading causes of cancer deaths in women:

  1. ________
  2. _______
  3. _______
A
  1. Lung
  2. Breast
  3. Colorectal
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5
Q

Leading causes of death in adolescents:

Death rate for teen _______ is higher than for _______

A

males; females

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6
Q

Leading causes of death in adolescents:

  1. ____________ —> _______ (39.5%)
  2. _________ (16.8%)
  3. _________ (14.3%)
A
  1. accidents —> MVCs
  2. Suicide
  3. Homicide
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7
Q

Leading causes of death in adolescents:

Suicide (2nd most common cause): Watch teens for signs of _______, excess ________, and suicidal behavior

A

depression

stress

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8
Q

Leading causes of death in adolescents:
Suicide:
_________ _______ between the adolescent and the parents/caregivers is extremely important in preventing teenage suicide

A

open communication

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9
Q

Leading causes of death in adolescents:
Homicide (3rd most common cause of death):
Nonfatal and fatal violence are much higher among _______ people compared to any other age group

A

young

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10
Q

Leading cause of mortality by age group:
Birth to 12 months:
_________ ___________

A

congenital malformations (20.3%)

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11
Q

Leading cause of mortality by age group:
Ages 1 to 44 years:
__________ __________

A

unintentional injuries

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12
Q

Leading cause of mortality by age group:
Ages 45 to 64 years:
_________

A

cancer

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13
Q

Leading cause of mortality by age group:
Ages 65 and older
_________ _________

A

heart disease

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14
Q

Life expectancy:

Average life expectancy is _____ years

A

78.6

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15
Q

Cancer statistics:
Prevalence:
Most common cancer: ________ cancer

A

skin

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16
Q

Cancer statistics:
Prevalence:
Most common TYPE of skin cancer:

A

basal cell carcinoma

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17
Q

Cancer statistics:
Prevalence:
Skin cancer: (the most common type of cancer)
___________ causes the majority of skin cancer deaths

A

melanoma

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18
Q

Cancer statistics:
Prevalence:
Most common cancer by gender (prevalence, not mortality):
Men: _______ cancer

A

prostate

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19
Q

Cancer statistics:
Prevalence:
In men, there are more cases of (the most common cancer) __________ cancer (this is PREVALENCE), but the cancer that causes the most deaths (MORTALITY) is _______ cancer

A

prostate

lung

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20
Q

Cancer statistics:
Prevalence:
Most common cancer by gender (prevalence, not mortality):
Women: _________ cancer

A

breast

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21
Q

Cancer statistics:
Prevalence:
In women, there are more cases of (the most common cancer) __________ cancer (this is PREVALENCE), but the cancer that causes the most deaths (MORTALITY) is _______ cancer

A

breast

lung

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22
Q

Cancer statistics:
Prevalence:
Most common cancer among all children:
_________

A

ALL (acute lymphoblastic leukemia) - 34% of all cancers in children

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23
Q

Screening tests:
Sensitivity:
A sensitive screening test is very good at identifying/detecting those people who ______ the disease (true ________)

A

have

positive

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24
Q

Screening tests:
Sensitivity:
An easy way to remember is to think of “sensitivity - rule ____”

A

in (“SIN”)

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25
Q

Screening tests:
Specificity:
An easy way to remember is to think of “specificity - rule _______”

A

out (SPOUT)

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26
Q

Screening tests:
Specificity:
A specific screening test is very good at identifying/detecting those people ______ the disease (true ________)

A

without

negative

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27
Q

Primary prevention:

Is _______ of a _____/_______

A

prevention; disease/injury

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28
Q

Primary prevention:

Individual actions such as ______ ______, ______, and helmets. Gun safety. Immunizations.

A

nutritious diet; seatbelts

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29
Q

Primary prevention:

Federal programs include immunizations, ______, and ______ laws

A

OSHA

EPA

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30
Q

Primary prevention:
______ prophylaxis for primary prevention of _____ and ____ cancer in adults aged 50 to 59 years who have a 10% risk or higher

A

ASA
CVD
colon

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31
Q

Secondary prevention:
Any _________ tests. Pap smears, mammos, CBCs to detect anemia, depression questionnaires, STIs, CAGE questionnaire, testing for Hep C, and having a person with a hx of MI, TIA, or CVA take an ASA or statin daily to prevent a ________ stroke or MI

A

screening

second

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32
Q

secondary prevention:

Is early ______ of a disease to ________ bodily damage

A

detection; minimize

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33
Q

Tertiary prevention: Prevention of disease _________, _________, _______ groups, education on _________.

A

progression

rehabilitation, support; equipment

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34
Q

Tertiary prevention:

Support groups such as ________, breast cancer support groups, ______ support groups

A

AA

HIV

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35
Q

Tertiary prevention:
_________ for patients with preexisting disease such as DM and HTN. This includes avoidance of ______ _______ and proper use of _______ or other medical equipment

A

Education

drug interactions; wheelchairs

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36
Q

Tertiary prevention:

Cardiac rehab, _____ and ______

A

PT; OT

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37
Q

Tertiary prevention:

Any treatment for ______ _______

A

active disease

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38
Q

USPSTF

ASA use to prevent CV disease and _____ _____ in age ___ to _____ with equal to ore more than 10% risk

A

colorectal cancer

50 to 59

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39
Q

USPSTF
ASA use to prevent CV disease - initiate lose-dose ASA therapy use for primary prevention of CV disease and colorectal cancer in patients with life expectancy of at least ___ years and who are willing to take low-dose aSA for at least ten years

A

10

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40
Q

USPSTF
Breast cancer:
Baseline mammo: Start at age _____ and repeat every ___ years until the age of _____ years

A

50

2; 74

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41
Q

USPSTF:
Mammograms:
Age ___ years or older:
Insufficient evidence for routine mammo

A

75

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42
Q

USPSTF: breast cancer -
the recommendation to start at age 50 and repeat every 2 years does not apply to women with known genetic mutations, familial breast cancer, hx of chest radiation at a young age or previously dx with breast lesion, who may benefit from screening mammos starting at age ____

A

40

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43
Q

USPSTF:
Colorectal cancer :
Baseline screening should start at age _____ until _____.
Age ____ to ___ years: Against routine screening but there may be cosiderations, individualize screenings as needed
Older than age ____: Do not screen

A

50; 75
76; 85
85

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44
Q

USPSTF:
Colorectal cancer:
Three screening methods are acceptable:
HSFOBT for ____ consecutive stool samples annually
Flex sigmoid or CT colonography every ___ years
Colonoscopy every _____ years

A

3
5
10

45
Q

USPSTF: lipid disorders

Total lipid profile after a ___-hr minimum fast

A

9

46
Q

USPSTF: lipid disorders
The USPSTF recommends the use of low-to moderate-dose statin when all of the following criteria are met:
Age ____ to ____ years
The patient has one or more risk factors for CVD (dyslipidemia, _____, ____, _______)
The patient has a calculated 10-year risk of CV event of ____% or greater
Age 76 or greater without hx of heart attack or stroke: insufficient evidence

A

40 to 74
DM, HTN, smoking
10

47
Q

USPSTF:
Ling cancer:
Screening for persons who smoke (____ pack-years) or have quit in the past ____ years

A

30

15

48
Q

USPSTF:
Lung cancer:
Age ___ to ____ years: Annual screening with low-dose CT

A

55 to 80

49
Q

USPSTF:
Lung cancer:
Discontinue screening once person has not smoked for _____ years or develops a health problem that substantially limits life expectancy or the ability or willingness to have curative lung surgery

A

15

50
Q

USPSTF:
Prostate ca:
Grade ___: ___ recommended

A

D; NOT

PSA screening not recommended

51
Q

USPSTF:
Ovarian ca:
Grade ___: ___ recommended

A

D; NOT

52
Q

USPSTF:
Ovarian ca:
Very high risk women with BRCA1 and BRCA2 mutations are ____ ____ ______.
If ovarian cancer screen is done, ______ ____ with _____ is ordered.
The screening starts at age 30.

A

referred to specialist
transvaginal ultrasound
CA-125

53
Q

USPSTF:
Ovarian ca:
High-risk women: Refer to genetic counseling. Look for fam hx of having 2 or more first-to second-degree relatives with a hx of ovarian ca; Women of ______ ______ ethnicity with first-degree relative with breast or ovarian cancer.

A

Ashkenazi Jewish

54
Q

USPSTF:
skin cancer counseling:
Recommended for children, adolescents, and young adults ages ___ to ____ with fair skin
Education includes avoidance of sunlight from ___ to ___, use of SPF ____ or higher

A

10 to 24
10 AM to 4 PM
15

55
Q 
USPSTF:
Routine screening is not recommended for the following conditions:
P
O
O
T
A

Prostate ca
Ovarian Ca
Oral Ca
Testicular ca

56
Q

USPSTF:
Breast cancer:
Breast self-exam has a grade ___ recommendation which recommends _____ teaching them.

A

D

against

57
Q

USPSTF:
Blood pressure: Start at age ___ or older and recommends obtaining measurements ______ of _____ _______ for diagnostic confirmation before starting treatment

A

18

outside clinical setting

58
Q

USPSTF:
Depression:
Start screening adolescents for major depressive disorder starting at age ____ to _____ years.
always screen the general adult population. For pregnant or postpartum women, use the _____ _____ ____-

A

12 to 18

Beck Depression Inventory

59
Q

USPSTF:
Diabetes mellitus:
Age _____ to ____ years if ______ or _____

A

40 to 70 overweight or obese

60
Q

USPSTF:
Obesity:
start at age ______ to _____ years and offer or refer to intensive _______ interventions

A

6; 18

behavioral

61
Q

USPSTF:
STIs:
Start screening at the onset of _______ ______.
Offer high-intensity behavioral counseling.

A

sexual activity

62
Q

USPSTF:
Skin cancer screening:
_______ evidence. Routine screening is ______

A

Insufficient; not recommended

63
Q

USPSTF:
Osteoporosis:
Start screening at age _____ years or older.
May start earlier if a younger woman has a fracture risk equal or greater than that of a 65 year-old White woman (chronic steroids)

A

65

64
Q

USPSTF:
Ovarian ca:
______ routine screening. Do not screen for except for high risk.

A

Against.

65
Q

USPSTF:
Pancreatic cancer.
For or against routine screening?

A

Against.

66
Q

Risk factors:
Breast cancer:
-OIder age: Age ____ years of older is most common risk factor

  • Previous hx of breast ca
  • ___ or more first-degree relatives with breast ca
  • ___ menarche and _____ menopause, nulliparity (longer exposure to estrogen)
  • Obesity
A

50
2
early; late

67
Q 
Risk factors:
Cervical cancer:
Multiple sex partners (greater than \_\_\_\_ lifetime)
\_\_\_\_\_\_\_ age of onset
immunosuppression and \_\_\_\_\_\_\_
A

4
younger
smoking

68
Q 
Risk factors:
Colorectal cancer:
-History of \_\_\_\_\_\_\_ polyposis
-\_\_\_\_\_-degree relative with colon cancer
-\_\_\_\_\_ disease
A

familial
first
Crohn’s

69
Q 
Risk factors:
Prostate cancer:
Age \_\_\_\_ or older
\_\_\_\_\_\_\_ ancestry
\_\_\_\_\_-degree relative with prostate ca
A

50
African
first

70
Q 
Risk factors:
STIs:
Multiple sex partners
earlier age of onset of sexual activity
new partners (defined as < \_\_ months)
Hx of STD
homelessness
A

3

71
Q

Vaccines and immunizations:
Hep B vaccine
Total of ___ doses at age ___, ___, & ____ months.
Need a minimum interval of ____ weeks between doses one and two.

A

3
age 0, 1, 6 months
4

72
Q

Vaccines and immunizations:
Hep B vaccine:
If series is not completed, do not restart the series. Catch up until _____-dose series is completed

A

3

73
Q

Vaccines and immunizations:
influenza vaccine:
Start giving at the end of _______ of each year. It takes ____ weeks after the shot for a person to develop antibodies.

A

October

2

74
Q

Vaccines and immunizations:
influenza vaccine:
As long as influenza viruses circulate, vaccination should continue to be offered, even into _______ or later.

A

January

75
Q

Vaccines and immunizations:
influenza vaccine:
Health care personnel who work with patients older than _____ years should be vaccinated.
If a person with an egg allergy only experiences hives, an influenza vaccine can be administered.

A

50

76
Q

Vaccines and immunizations:
influenza vaccine formulations:
Inactivated and recombinant influenza vaccines:
________ and __________ vaccines given by IM injection in the arm are preferred.

A

Trivalent; quadrivalent

77
Q

Vaccines and immunizations:
influenza vaccine:
High-dose _______ influenza vaccine is for people age ____ or older

A

trivalent

65

78
Q

Vaccines and immunizations:
influenza vaccine:
Recombinant ______ influenza vaccine that is egg-free is approved for persons age ____ years and older (Flublok)

A

trivalent

18

79
Q

Vaccines and immunizations:
influenza vaccine:
Quadrivalent offers broader protection and is indicated for age ____ years and older

A

4

80
Q

Vaccines and immunizations:
influenza vaccine:
LAIV (Live attenuated influenza vaccine)
Only for healthy persons aged ___ to ____ years.
Some antivirals should be avoided 48 hours before and ____ days after vaccination b/c they interfere with antibody production

A

2 to 49

14

81
Q 
Vaccines and immunizations:
influenza vaccine:
LAIV contraindications:
Pregnancy
chronic disease
children on \_\_\_\_\_ therapy aged 2-17 years
A

Aspirin

82
Q

Vaccines and immunizations:
influenza vaccine:
Age-appropriate _________ (RIV) or cell-cultured flu vaccines are an option for patients who refuse egg-based influenza vaccine.

A

recombinant

83
Q

Most flu vaccines (including nasal spray) are manufactured using egg-based technology. What are the implications for patients?
Egg allergy affects ____% of children but only ___% of adults

A

1.3%; 0.2%

84
Q 
Tetanus vaccines (Tdap and Td):
Give every \_\_\_\_ years for lifetime
A

10

85
Q

Tetanus vaccines:
Boosters:
For “dirty”/contaminated wounds, give a booster if the last dose was more than ____ years prior

A

5

86
Q

Vaccines and immunizations:
Tetanus vaccine:
Infancy and children younger than age 7 years: Use ___ form

A

DTaP

87
Q

Vaccines and immunizations:
Tetanus vaccine:
Age 7 years and older:
Use only ____ or ____ forms of the vaccine; Give one _______ dose (lifetime) to replace one ____ dose

A

Td; Tdap

Tdap; Td

88
Q

Vaccines and immunizations:
Tetanus vaccine:
The _____ can be substituted for a single dose of ___ once in a lifetime, starting at age ____ to ____ years

A

Tdap; Td

11 to 12

89
Q

What is done if a patient has a tetanus-prone wound and vaccination status is unknown?
Administer immediate dose of ____ vaccine and the tetanus ___________ injection as soon as possible

A

Td/Tdap

immunoglobulin

90
Q 
Vaccines and immunizations:
Tetanus vaccine:
Which would are considered highest risk for tetanus infection?
\_\_\_\_\_ wounds
Wounds with \_\_\_\_\_\_\_\_\_\_ tissue
\_\_\_\_-contaminated wounds
\_\_\_\_\_ injuries
A

puncture
devitalized
soil
crush

91
Q

Vaccines and immunizations:
Pneumococcal vaccine:
_____ (or _______): All adults age 65 years or older or if high risk for pneumococcal disease (age ___ to ___ years)

A

PPSV2e or Pneumovax

92
Q

Vaccines and immunizations:
Pneumococcal vaccine:
____ (or _______): All children younger than ___ years of age or at high risk for pneumococcal disease. It is also recommended for all adults age ___ years or older.

A

PCV13 or Prevnar

65

93
Q

Vaccines and immunizations:
Pneumococcal vaccine:
Age 65 years of older: CDC recommends giving ____ first (if never had PPSV23); then 12 months after, administer PPSV23 (better immunogenic response)

A

PCV13

94
Q 
Vaccines and immunizations:
Pneumococcal vaccine:
Highest risk of fatal pneumococcal infection:
\_\_\_\_\_ diseases
Anatomical or functional asplenia
Any immunocompromise
generalized malignancy or cancers of the blood (leukemia, lymphoma, multiple myeloma)
Renal diseases
hx of organ or bone marrow transplant
A

chronic (DM, alcoholism, CSF leaks, asthma, chronic hepatitis)

95
Q

Vaccines and immunizations:
Pneumococcal vaccine:
If a person is vaccinated before the age of 65 with Pneumovax, what is recommended?
Give a booster dose of ________ ___ years after the initial dose

A

Pneumovax; 5

96
Q

Vaccines and immunizations:
Shingles vaccine:
Zostavax is a ___ _____ virus vaccine

A

live attenuated

97
Q

Vaccines and immunizations:
Shingles vaccine:
Age ___ years: Give one-time dose by ____ route.
A past hx of shingles is not a contraindication for receiving the shingles vaccine.

A

60; SQ

98
Q

Vaccines and immunizations:
Shingles vaccine:
The shingles vaccine can be administered to persons if they have never had a ________ infection.

A

chickenpox

99
Q

Vaccines and immunizations:
Shingles vaccine:
Certain antivirals can decrease immunological response if taken 24 hours before or ___ days after vaccination

A

14

100
Q

Vaccines and immunizations:
Shingles vaccine:
May cause exacerbation of _________ and _______

A

asthma; polymyalgia rheumatica (PMR)

101
Q 
Vaccines and immunizations:
Shingles vaccine:
Risk factors for shingles:
Older age (\_\_\_\_ years or older)
immunocompromised (HIV, steroids, chemo)
leukemia, lymphoma
A

60

102
Q 
Vaccines and immunizations:
Shingles vaccine:
Contraindications:
pregnancy or breastfeeding
\_\_\_\_\_\_, lymphomas, or other malignancies of bone marrow
immunocompromise
A

leukemia

103
Q

Vaccine facts:
What age group should receive the shingles vaccine?
Give a one-time dose at the age of ____ years or older (even if the patient has already had shingles).
The youngest age that Zostavax can be given is ___ years of age

A

60

50

104
Q

Vaccines and immunizations:
Shingles vaccine:
Can any person who has never had chickenpox develop shingles?

A

No, they cannot.

105
Q

Vaccines and immunizations:
Shingles vaccine:
How long are persons with shingles contagious?
Shingles is infections until all the skin lesions are ____ and _____. Follow _______ precautions.
About half of cases of shingles occur in persons age ___ years and older.

A

dry; crusted
contact
60

106
Q

Which vaccine, the shingles or the varicella vaccine, contains more varicella zoster virus?

A

The shingles vaccine (about 14 times more compared to varicella vaccine)

107
Q

Primary, secondary, or tertiary prevention:

After a heart attack patient gets prescribed a statin.

A

Secondary

108
Q

Screening test for lung cancer is a :

A

low-dosed HELICAL CT

AANP certification exam (10 decks)

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