Exam #2: Preventative Geriatrics

Question 1

What is the purpose of Geriatric Prevention?

Answer 1

• Improve function (ADLs, IADLs)

- Improve quality of life

Question 2

What are the three types of disease prevention?

Answer 2

• Primary
• Secondary
• Tertiary

Question 3

What is an example of primary disease prevention?

Answer 3

Immunization

Question 4

What is secondary disease prevention?

Answer 4

Screening & detection of asymptomatic conditions

Question 5

What is the USPSTF?

Answer 5

US Preventative Services Task Force

Question 6

What does the USPSTF do?

Answer 6

Determines the efficacy of preventative service & offers screening recommendations

Question 7

What does A or B recommendation from the USPSTF mean?

Answer 7

Recommended

Question 8

What does C recommendation from the USPSTF mean?

Answer 8

Physician-decision

Question 9

What does D recommendation from the USPSTF mean?

Answer 9

Do NOT do

Question 10

What does I recommendation from the USPSTF mean?

Answer 10

Not enough evidence to say on way or another

Question 11

When is a woman most likely to die from breast cancer?

Answer 11

More than half of breast cancer deaths occur after the age 65

Question 12

What are the screening recommendations for women 50- 74 for breast cancer?

Answer 12

Biannual screening with mammography (Grade B)

Question 13

What are the screening recommendations for women >74 for breast cancer?

Answer 13

Grade I

Question 14

What are the USPSTF recommendations for teaching self-breast exam to women?

Answer 14

Grade D

Question 15

What are the USPSTF recommendations for clinical breast exam in women older than 40?

Answer 15

Grade I

Question 16

What are the USPSTF recommendations for cervical cancer screening in 65 year olds w/ otherwise had adequate prior screening & are NOT high risk?

Answer 16

Do NOT screen

Question 17

What are the USPSTF recommendations cervical cancer screening in patients s/p hysterectomy & no hx of high grade cervical lesion?

Answer 17

Do NOT screen

Question 18

Why does COPD put patients at risk for osteoporosis?

Answer 18

Chronic steroids

Question 19

What are the major risk factors for osteoporosis?

Answer 19

• Low weight

Question 20

What are the USPSTF recommendations for DEXAscan?

Answer 20

Women 65 y/o & older should screening

*****Note that in men, screening is Grade I

Question 21

What are the major risk factors for prostate cancer?

Answer 21

• First degree relative with prostate cancer

- African American

Question 22

Why is there controversy surrounding PSA-screening?

Answer 22

• It is not known if screening reduces risk of death

- PSA is nonspecific- can be elevated in prostatits & BPH

Question 23

What are the USPSTF recommendations for PSA screening?

Answer 23

Grade D

Question 24

What is the harm of PSA screening?

Answer 24

For every 3,000 PSA tests

• 120= ED for incontinence due to tx
• 6 CV events due to tx
• 3 DVT due to tx
• 1 death from surgical tratment

Question 25

What patient population is colon cancer highest in?

Answer 25

African American

Question 26

What are the USPSTF screening recommendations for colon cancer?

Answer 26

• Occult blood testing
• Sigmoidoscopy
• Colonoscopy

Any of these at 50 years old & continuing until 75 years is Grade A

Question 27

When does the USPSTF recommend AGAINST colon cancer screening?

Answer 27

85 years old, or older