Family Medicine-Williams

Question 1

T/F Health care screening is harmful.

Answer 1

true.

Question 2

What is screening?

Answer 2

looking for a specific disease that is in a pre-symptomatic state
often a term used when referring to populations or large groups of people

Question 3

What are some disease characteristics to consider when deciding whether or not we should screen?

Answer 3

seriousness
effectiveness of early detection: need to have a treatment
epidemiology-prevalence
availability of treatment

Question 4

What are some test characteristics to consider when deciding if we should screen?

Answer 4

cost
ease of testing
sensitivity
safety
specificity

Question 5

T/F Screening for rare diseases leads to many false negatives.

Answer 5

False. Many false positives.

Ex: PKU 1/20K

Question 6

If you had to choose sensitive or specific, but not both, which would you choose?

Answer 6

sensitive!

If someone screens negative–you want to make sure they don’t have disease.

Question 7

Why can screening have adverse effects?

Answer 7

the risks of the follow up tests

more diagnostic tests & biopsies and risk for wound infection etc. + anxiety

Question 8

Why do we screen for HTN?

Answer 8

risk for MI
less risk for heart attack if we treat high blood pressure
all adults (over 18) screened.

Question 9

Why do we screen people for lipid disorders? Who should be screened?

Answer 9

contributes to heart attacks
all males>34
males & females>20 who are at increased risk
everyone over 20 once every 5 years

Question 10

Do we screen patients for lung cancer?

Answer 10

most common cancer death in US
recommended annual screening for lung cancer with low dose computed tomography if 55-80 who have a 30 pack year hx of smoking. Who currently smoke or have quit w/i last 15 years.

Question 11

Why do we screen for Type 2 Diabetes Mellitus?

Answer 11

def need to screen & treat if patients have HTN or hyperlipidemia. Greater risk of MI.
need to screen with BP>135/85
if obese

Question 12

What’s the deal with breast cancer screening?

Answer 12

50-74 mammogram screening every other year
recommend against teaching self breast exams
clinical breast exam every 3 years in 20-30s

Question 13

What’s the deal with screening for colorectal cancer?

Answer 13

50-74 flex sig, colonoscopy, FOB

don’t screen past age 85

Question 14

What’s the deal with screening for chlamydia & gonorrhea?

Answer 14

all women 24 & younger who have ever had sex should be tested for this
or if over this age & high risk: multiple partners, unmarried, hx of STDs, sex work, drug use

Question 15

What’s the deal for screening patients for HIV?

Answer 15

screen all adolescents & adults 15-65

Question 16

What’s the deal with screening for cervical cancer?

Answer 16

all women 21-65 every 3 years
30-65 If HPV neg…then do combo of HPV & Pap every 5 years.
this is for people who have never had an abnormal pap

Question 17

What’s the deal with prostate cancer screening?

Answer 17

USPSTF recommends against PSA screening for prostate cancer

problematic b/c of false positives & b/c of the lack of progression of most prostate cancers

Question 18

WHat’s the deal with screening for abdominal aortic aneurysm?

Answer 18

one time ultrasound in men 65-75 who have ever smoked

Question 19

What are some conditions that we don’t screen for?

Answer 19

thyroid
liver
kidney
bladder
ovarian
vit D deficiency

Question 20

These are the USPTF guidelines.

Answer 20

Lung Cancer: 55-80 w/ hx of smoking LDCT if 30 py hx of smoking currently smoking or quit in last 15 yrs
Cervical: women 21-65 pap smear every 3 years OR 30-65 hpv + pap every 5 years
Breast: 50-74 every other year; no breast self exams
prostate: don’t test PSA
colon: 50-75; fecal occult blood testing, sigmoidoscopy, or colonoscopy; past age 75 don’t screen.