Clinical and community preventative services

Question 1

Discuss the differences between primary secondary and tertiary prevention systems

Answer 1

Primary prevention
• Interventions which prevent disease before the disease process begins
• Examples: immunizations, exercise, healthy eating, creating environments supporting healthy living

Secondary prevention
• Interventions which identify and mitigate disease before it is clinically apparent
• Example: pap smear and colorectal CA screening

Tertiary prevention
• Treatment and rehabilitation of a disease once it has started to avoid further complications
• Example: Insulin treatment for diabetes

Question 2

Which of the following are overarching goals of HP 2020?

1. Attain high quality longer lives
2. Achieve health equity
3. Create health promoting environments
4. Promote quality of life, healthy development and healthy behaviors
5. All of the above

Answer 2

All the above

Question 3

USPSTF

Answer 3

The United States
Preventive Services
Task Force (USPSTF)

Question 4

TFCPS

Answer 4

The Task Force on
Community Preventive
Services (TFCPS)

Question 5

AHRQ

Answer 5

• The Agency for Healthcare Research and Quality (AHRQ)

Question 6

What type of prevention is “screening”?

Answer 6

Secondary

Question 7

Steps in USPSTF Process

Answer 7

1. Create Research Plan
2. Compile Evidence Report
3. Develop Recommendation
4. Disseminate Recommendation
   (Public Input incorporated into all of the above)

Question 8

What do we do with the USPSTF grading system?

Answer 8

A/B - Offer or provide the service
C - Offer to some based on individual circumstances
D - Discourage use
I - Uncertain, ye has been warned

Question 9

You are seeing Ms. Z, 22-year-old recruit, for an annual women’s health examination, including pelvic examination and Pap smear for cervical cancer screening. She is sexually active in a long-term monogamous heterosexual relationship. She has no specific medical complaints, her vital signs (including weight and BMI) are normal, and history, family history, and physical examination are unremarkable.

QUESTION: What screening (in addition to pap) do you routinely provide Ms. Z?

1. Screening for Asymptomatic Bacteriuria
2. Chlamydia
3. Hepatitis B
4. Hypercholesterolemia
5. All of the above

Answer 9

Chlamydia

Question 10

You have time during this visit to initiate a discussion of one additional clinical preventive service with Ms. Z. [Recall previous scenario]

QUESTION: Based on the USPSTF recommendations, which of the following clinical preventive services should you discuss with her at this visit?

1. Avoid sunburn/ excessive sun exposure
2. Participate in moderate physical activity at least 30 min 5 d/week
3. Teach Breast Self-Exam
4. Take a daily MVI w/ 0.4-0.8 mg Folic Acid

Answer 10

Daily MVI

Question 11

QUESTION: Which one of the following cancers HAS shown benefit from screening)?

• Bladder
• Breast
• Lung
• Pancreatic
• Testicular

Answer 11

Breast

Question 12

Based on the TFCPS syntheses, which of the following interventions are strongly recommended to prevent/control Obesity?

1. Provider education
2. Provider feedback
3. Provider reminders
4. Worksite programs
5. School-based programs
6. All of the above

Answer 12

Worksite programs

Question 13

Which of the following interventions has been shown to reduce tobacco initiation?

1. Increasing the unit price of tobacco products
2. Mass-Reach health communication interventions
3. Both of the above

Answer 13

Both

Question 14

The TFCPS recommends
Community-scale urban
design and land use policies

True or false

Answer 14

True

Question 15

The TFCPS recommends
Point-of-decision prompts
to encourage use of stairs

True or False

Answer 15

True

Question 16

The TFCPS recommends
College-based physical
education and health
education

True or False

Answer 16

False

Question 17

Recommended to prevent excessive alcohol use?

1. Regulation of Outlet
Density
2. Maintain limits on days of
sale
3. Increasing alcohol taxes
4. Enhanced enforcement of
laws prohibiting sales to
minors
5. Electronic screening and
brief intervention
6. All of the above

Answer 17

5

Question 18

The most common reason interventions on
the CG’s web site are not recommended

1. Recommended Against (strong evidence)
2. Insufficient Evidence
3. Recommended Against
   (sufficient evidence)

Answer 18

2