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Prevention Across the Lifespan > Final > Flashcards

Final Flashcards

1
Q

T/F: Since the introduction of screening in the USA, incidence of CRC has decreased while incidence of breast and prostate CA have increased

A

true

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2
Q

Begin discussion on bicycle helmets at what visit?

A

*Begin discussion on bicycle helmets at the 2 year visit

Sooner if a passenger of a parent on a bicycle

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3
Q

Children exposed to tobacco smoke are at increased risk for what 3 things?

A

asthma
SIDS
URIs

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4
Q

-graphical representation of the family history

A

pedigree

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5
Q

what type of prevention:
provided to individuals who clearly have a disease, and the goal is to prevent them from developing further complications.

A

Tertiary Prevention

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6
Q

11 geriatric syndrome

A
  • Cognitive impairment
  • Delirium
  • Incontinence
  • Malnutrition
  • Falls
  • Gait disorders
  • Pressure ulcers
  • Sleep disorders
  • Sensory deficits
  • Fatigue
  • Dizziness
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7
Q

refers to a single gene (few genes)

A

genetics

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8
Q

4 multi modal approaches to treating CRPS

A
  1. psychological
  2. pharmacological
  3. physiotherapy
  4. interventional procedures
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9
Q

peak performance occurs at waht age?

-loss of reproductive ability what age?

A

pp: 20-30

loss of reproductive: 45-55

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10
Q

__% of teens have sent a sexting message

-emotional and legal impacts

A

20%

Considered a criminal offense –> leads to suspension, permanent record, police involvement

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11
Q

begin asking at the __ year WCC about conflict and bullying

*__% of children are either bullied or a bully

A

11 yr

30%

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12
Q

Older individuals are at greater risk for adverse drug events due to:

A

metabolic changes and decreased drug clearance associated with aging

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13
Q

Adults surviving into late life suffer from high rates of chronic illness; ___% have at least one and ___% have at least two chronic conditions

A

80% have 1 chronic illness

50% have at least 2 chronic illnesses

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14
Q

what happens to esophageal skeletal muscle w/ age?

A

atrophies at upper third of esophagus–> swallowing problesm–> risk for aspiration

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15
Q

recommendations for prostate CA screening

A
  • reasonable in healthy men 55-69 y/o
  • men over 75 should NOT be screened
  • PSA or FOBT
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16
Q 
sx: Headaches (severe,
recurrent)
often worse in AM or
supine
Papilledema, peripheral vision
loss possible
A

Psuedotumor Cerebri

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17
Q

5 Indications for genetic counseling and/or testing (clues to genetic disorders)

A
  1. ‘Known’ Genetic Disorder
  2. Positive Family History
  3. Premature presentation
  4. Unusual presentation
  5. Unexpected natural progression
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18
Q

sx:
pelvic obliquity
weak core strength
myofascial tenderness, muscle spasm

A

sacroillitis (sciatica)

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19
Q

4 pillars of health for geriatric population

A
  1. diet
  2. exercise
  3. sleep
  4. attitude
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20
Q

sx: acanthosis nigrican

A

-impaired glucose metabolism

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21
Q

how should firearms be stored?

A
  • The gun should be locked away

- Ammunition should be locked away separate from the gun

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22
Q
  • Anesthetic medication and a steroid are injected into the epidural space around a disk under fluoroscopic guidance
  • Controversial due to little evidence of long term pain relief
  • Effective for patients who are not surgical candidates
A

transforaminal epidural steroid injection

*used for back pain tx

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23
Q

GI comorbidities associated w/ childhood obesity

A
  • non-alcoholic fatty liver disease
  • gallstones
  • constipation/encopresis
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24
Q

Geriatric patients should be screened for colon cancer until age __

A

75

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25
Q

saddle anethesia and loss of bowel/bladder control are assoicated w/ what dermatomes

A
  • Saddle Anesthesia(S3-S5)

- Loss of Bowel/Bladder control (S2-S4)

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26
Q

normal changes that occur with age in various systems including: Cardiovascular, Pulmonary, Renal, Gastrointestinal, Musculoskeletal

A

programmed aging

*genetics and environmental factors also play a role

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27
Q

a term that is commonly applied to mild or moderate protein energy malnutrition in this country

A

failure to thrive

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28
Q

endocrine comorbidities of obesity in children

A
  • impaired glucose metabolism
  • DM2
  • PCOS
  • hypothyroidism
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29
Q

Colorado Law:
Rear-Facing Car Seat
Up to ____ AND ___

AAP recommends what?

A

Rear-Facing Car Seat
Up to age 1 AND 20 lbs

-AAP now recommends Rear-Facing Car Seats until 2 years of age or until they reach the height/weight requirement of their car seat

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30
Q

An apparent loss of physiologic reserves in older adults leads to intolerance to challenges to their homeostasis
-the older person is continually expending reserves to compensate for primary age changes

A

homeostenosis

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31
Q

Compression of multiple nerve roots below the Conus Medullaris (L1-2)
Numbness and tingling in groin

A

cauda equina syndrome

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32
Q

____: the proportion of people without the target disorder who have a negative test result

A

Specificity: the proportion of people without the target disorder who have a negative test result

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33
Q

SUN SAFETY

  • limit sun exposure between____
  • use sunscreen of at least SPF __ and reapply ___
  • sunglasses should block what rays
  • wear wide brimmed hat __ inches or has ___
A
  • limit sun exposure between 10am-4pm
  • use sunscreen of at least SPF 15 and reapply every 2 hrs or after swimming
  • sunglasses should block UVA and UVB rays
  • wear wide brimmed hat 3 inches or has bill
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34
Q

do these supplements have evidence to help with weight loss

  • Tiratricol
  • 5-HTP
  • 7-Keto-DHEA
  • Bean pod
  • Caralluma
  • Chitosan
  • Chromium
  • Green tea
  • Guarana
  • Guggul
  • Licorice
  • Magnolia
  • Rose hip
  • Willowbark
A

ineffective/insufficient evidence

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35
Q

how much exercise is need to:
prevent weight gain:
maintain weight loss:

A

prevent weight gain: 150-200min/wk moderate intensity

maintain weight loss: 200-300+ min/wk moderate intensity

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36
Q

how many pairs of chromosomes and how many genes in humans

A

23 paris of chromosomes

~22,000 genes

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37
Q

Beginning talking about drugs, alcohol and tobacco at the __ year WCC

A

Beginning talking about drugs, alcohol and tobacco at the 9 year WCC

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38
Q

(very severe FTT): body weight under 60% median (50th %ile) for age

A

Marasmus

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39
Q

T/F: early detection of CA improves survival even if death isn’t delayed by early screening?

A

true

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40
Q

__ has a strong association w/ dependency in activities of daily living

A

geriatric syndromes

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41
Q

Room-Sharing = __
vs
Bed sharing = ___

A

Room-Sharing = OK
Article: May decrease SIDS as much as 50%

Bed-Sharing = NOT OK
Including In-Bed Co-Sleepers

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42
Q

Keep child in booster seat until ____ tall

A

Keep child in booster seat until 4’9” (57”) tall (MAY be after the child is 8)

  • Shoulder belt should cross at the chest and shoulder (Not at the neck)
  • Lap belt should cross at the upper thighs (Not at the abdomen)
  • Knees should bend at the edge of the seat and feet should dangle down
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43
Q

goal of geriatric care

A
  • promote wellness and independence,

* Decline in function and loss of independence are NOT an inevitable consequence of aging

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44
Q

genetic testing can help with what>

A
  1. diagnosis
  2. management strategies
  3. targeted treatment
  4. high-capacity DNA analysis
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45
Q

what Grade?

-clinicians may provide this service to selected patients depending on individual circumstances

A

Grade C

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46
Q

how much exercise is need to contribute to weight loss for:

  • Health benefits and minimal to no weight loss-
  • moderate weight loss-
  • larger weight loss
A
  • Health benefits and minimal to no weight loss- less than 150min/wk mod. intensity
  • moderate weight loss- 150-225min/wk mod. intensity
  • larger weight loss- 200-300+ min/wk of mod. intensity
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47
Q

what should the first action be if a child ingests a poison?

A

call poison control!

*do not use syrup of ipecac or charcoal as interventions

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48
Q

what PE do u do when someone presents w/ pain neck pain w/ flexion/extension-discogenic

A

Spurlings test

Looking for radicular sx

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49
Q

For breast-fed infants, need source of iron and zinc after what age

A

6 months

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50
Q

Restraint system allows for what 4 things?

A
  1. ejection risk to decrease
  2. distributes the energy load of the crash through bones rather than soft tissues (bones are stronger)
  3. limits the crash forces by prolonging the deceleration
  4. limits the contact with the vehicle and other occupants.
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51
Q

___ is the 3rd leading cause of death with ___ as the most common method used

A

firearms

*85% of all homicides were firearms-related

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52
Q

how many people over 80 have a neurological disorder (ie. alzheimers or parkinsonism)

A

1/3rd

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53
Q

sx: Oligomenorrhea (

A

PCOS

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54
Q

what Grade?
-certainty that the net benefit is moderate to substantial USPSTF recommends the service, there is a high certainty that the net benefit is moderate or there is moderate

A

Grade B

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55
Q

____: performed to determine the presence or absence of a specific disease or condition in symptomatic individuals.

A

Diagnosis: performed to determine the presence or absence of a specific disease or condition in symptomatic individuals.

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56
Q

6 Cardiovascular changes w/ aging?

A
  • procoagulant—> risk of DVT
  • increase CAD and HTN age
  • heart valves thicken and calcify
  • heart muscle thickens
  • arteries harden and veins lose tone (edema)
  • conduction is impaired (murmurs and afib)
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57
Q

advance care preferences for patients

A
  • MDPOA (MOST Important!!)
  • Colorado MOST form (CPR directive)
  • 5 wishes
  • Living will
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58
Q
  • Chance an average risk 50 year old will be diagnosed with CRC in their lifetime?
  • Chance an average risk 50 year old will die of CRC in their lifetime?
A
  • Chance an average risk 50 year old will be diagnosed with CRC in their lifetime? (5%)
  • Chance an average risk 50 year old will die of CRC in their lifetime? (2%)
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59
Q

-Children younger than ____ travel nearly as much as adults in a vehicle
~__ trips/day, ___ minutes/day

A

Children younger that 16 years travel nearly as much as adults in a vehicle

~3.4 trips/day, 45-50 minutes/day

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60
Q

3 rules of thumb to help patients w/ screening decisions

A
  1. be skeptical
  2. know your risk and benefits (absolue risk)
  3. patients are experts too and have preferences
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61
Q

red flags for back pain

A
  • CA
  • Compression fracture
  • corticosteroid use
  • Infection
  • duration greater 1month w/ no improvement w/ rest
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62
Q

when does weight typically drop off then rebound for children

A

drops off around age 2-4 y/o

-starts rebounding by 5

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63
Q

main proteins found in human milk and cow milk

A

human-whey

cow-casein

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64
Q

-Parents tend to ____ the child’s cognitive and sensory skills (how fast a car is coming)
Parents tend to _____ the child’s motor skills (ability to climb)

A

Parents tend to overestimate the child’s cognitive and sensory skills (how fast a car is coming)

Parents tend to underestimate the child’s motor skills (ability to climb)

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65
Q

___ is the final common pathway in nonorganic FTT and in most cases of organic FTT.

A

Failure to thrive

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66
Q

-Chance an average risk 50 year old man will be diagnosed with prostate cancer in his lifetime?

Chance an average risk 50 year old man will die of prostate cancer in his lifetime?

A
  • Chance an average risk 50 year old man will be diagnosed with prostate cancer in his lifetime? (20%)
  • Chance an average risk 50 year old man will die of prostate cancer in his lifetime? (3%)
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67
Q

key diet factors associated w/ childhood obesity

A
  1. Sweetened Beverages and Juice
  2. Fruit and Vegetable intake
    - fiber, low energy density
  3. Energy Dense foods
    - processed
  4. Restaurant Meals
    - Not just fast food, vs. Family Meals at home
  5. Large Portion Sizes
    - Especially poorly satiating starches
  6. Frequency of eating:
    - Schedule for meals/snacks ~q3hrs, breakfast qAM
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68
Q

Pet saftey recommendations

A
  • wait to get a dog until child is 4yr or older
  • don’t pet when eating or sleeping
  • treat dog bites immediately
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69
Q

polypharmacy in geriatrics leads to what 4 things

A
  • Prescribing errors
  • Cost
  • Incidence of adverse drug reactions and drug‐drug interactions
  • Prescribing cascades
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70
Q

3 things for facet pain back pain

A
  • facet joint injection
  • medial branch block
  • radiofrequency neurotomy
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71
Q

w/ acute back pain, ___% of time no specific source is found

A

80%

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72
Q

more than __% of deaths from flu are ppl over 65

A

90%

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73
Q
  • Chance an average risk 50 year old woman will be diagnosed with invasive breast cancer in her lifetime?
  • Chance an average risk 50 year old woman will die of breast cancer in her lifetime?
A

Chance an average risk 50 year old woman will be diagnosed with invasive breast cancer in her lifetime? (10%)

  • Chance an average risk 50 year old woman will die of breast cancer in her lifetime? (3%)
  • Mammography not decreasing late disease but mortality IS decreasing (b/c of treatment)
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74
Q

what PE do you do w/ someone w/ pain w/ flexion and extension- discongenic

A

Straight leg raise

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75
Q

__% of children find unwanted pornography on the internet

~__% of US children have been cyber-bullied

A

25% of children find unwanted pornography on the internet

~6% of US children have been cyber-bullied

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76
Q

___: ability to measure the actual value of the quantity being measured

A

Accuracy: ability to measure the actual value of the quantity being measured

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77
Q

when communicating w/ families about childs weight, discuss __ with parents and discus __ with child

A

w/ adult: AVOIDABLE health riks

w/ child: quality of life issues (sports, energy, confidence, clothing)

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78
Q

It is estimated that 1 in __ girls and 1 in __ boys are affected by child sexual abuse

A

It is estimated that 1 in 4 girls and 1 in 7 boys are affected by child sexual abuse

*40% are under the age of 6

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79
Q

what is the best diet for weight loss?

A

calories in less than calories out

  • no magic diet
  • adherence is key!
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80
Q

If the prevalence of a disease is low, is a positive result more likely to be a “real” positive or a “false positive?”

A

?

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81
Q

70% of obese children had 2 or more or waht

A 
low HDL
high LDL
HTN
insulin resistance
84% remained obeses at age 27
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82
Q

Approximately __ of community-dwelling persons age 65 years have a fall risk and ___ of those over 80 years of age fall each year

A

1/3rd

1/2

*hip fractures are life-changing

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83
Q

what 5 factors promote obestiy in adults

A
  • Food
  • Inactivity
  • drugs
  • environment (lack of sleep,time, food)
  • individual (genetics, fhx, knowledge)
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84
Q

6 problems with popular diets

A
  • too much of one nutrient and too little of other nutrients
  • Restrict liquids
  • Unrealistic weight loss promises
  • Expensive
  • Little variety and boring
  • Adherence is difficult
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85
Q

recommendations for colon CA screening

A
  • good idea for 50-75y/o
  • avoid after 85y/o

*best test is the one that gets done–> decreases you chance of getting and dying from colon CA

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86
Q

4 methods of pain control for back pain

A
  • myofascial release
  • interferential stimulation
  • phonophoresis
  • dry needling (myofascial tenderness, muscle spasms)
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87
Q 
sx: snoring most nights, apnea, poor sleep,
nocturnal enuresis,
AM headaches, fatigue,
poor school
performance
A

obstructive sleep apnea

13-33% of obese youth

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88
Q

5 S’s to calm a baby

A 
Swaddle
Swing
Shush
Suck
Side/Stomach position
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89
Q

Fx risk factors for childhood obesity

A
  • obesity
  • CVD (early MI, DM2, HTN, HLD,
  • hypothyroidism
  • psychiatric issues (eating disorders)
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90
Q

Diabetes mellitus – AGS recommends Hgb A1c ___% in healthy geriatric adults, 8‐9% in patients with multiple morbidities and lower life expectancy

A

7-7.1%

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91
Q

weight management strategies

A

surgery
pharmacotherapy
lifestyle modification (diet and exercise)

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92
Q

what type of prevention:
screening to identify risk factors for disease or the early detection of a disease among asymptomatic and at-risk individuals.

A

Secondary Prevention

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93
Q

what is considered the “good” fat and “healthy” fat

A 
monounsaturated fat (MUFA)
*in olive oils, nuts, avocados, canola oil, seeds

polyunsaturated fats (PUFA)

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94
Q

psychiatric comorbidities associated w/ childhood obesity

A
  • depression/anxiety

- eating disorder

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95
Q

the national weight control registry showed these4 things are associated w/ ppl who maintained their weight loss

A
  • eat breakfast
  • weigh themselves 1x per week
  • was less than 10hr of TV per week
  • exercise on avg 1 hr per day
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96
Q

over the counter weight loss supplements are most commonly used by

A 
women
minorities
25-34 y/o
college educated
obese/overweight
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97
Q

If teenager is in the front seat what should you do?

A

If teenager is in the front seat, move chair back as far as it can go

98
Q

USPSFT recommendations for who needs to lose weight:

AHA/ACC/TOC recommendations for who needs to lose weight:

A

USPST: BMI of 30+, possible waist circumference

AHA/ACC/TOC: BMI 30+ or BMI 25+ w/ 1 or more risk factor (waist circum, traditional risk factors)

99
Q

T/F: RCT’s demonstrate the superiority of screening colonoscopy over FOBT for reducing CRC mortality

A

False

100
Q

normal breastfeeding pattern

A
  • Very frequent initially (q 1-2 hr); gradually extends to q 3-4
  • Newborn - max interval 5 hr
101
Q

strategies to help treat childhood obesity

A
  • involve family
  • make plan to monitor change (increase awareness and accountability)
  • positive feedback/rewards
  • Motivational interviewing
  • *Know CORE VALUES!!
102
Q

depression is higher in what geriatric populations

A 
hospitalized
strokes
MI
CA
nursing homes (over 50%)
103
Q

Ideal intervention for weight management in adults:

  • ____ face-to-face counseling sessions with a trained interventionist in the first 6 months of treatment
  • Produce 1 year average ___% weight loss
A

14 or more

8%

104
Q

what happens w/ bone marrow mass and bone marrow fat w/ age

A

bone marrow mass- decreases
bone marrow fat- increases
*more sensitive to CA treatments

105
Q

in men, screen lipid panel for men 35 then until what age?

A

65

106
Q

what medications should be avoided in geriatrics?

A

Beer’s list criteria

ex. Diphenhydramin, NSAIDs, TCAs, benzodiazepines, amiodarone, antipsychotics, ambien, bladder anticholinergics

107
Q

how much of your plate should be fruits veggies

A

1/2 plate- fruits and veggies

108
Q

what BMIs define underweight, health weight, overweight, and obesity in adults?

A
  • Underweight BMI less than 18.5
  • Healthy weight BMI=18.5-24.9
  • Overweight BMI=25.0-29.9
  • Obesity BMI over 30.0
109
Q

Tobacco smoke can be measured up to ___away

A

Tobacco smoke can be measured up to 20 feet away

110
Q

90% of back pain problems occur at the ____ and ____ disks

A

L4-5 and L5-S1 disks

111
Q

4 popular weight loss supplements

A

Herbal CNS stimulants
Herbal diuretics
Herbal stimulant laxatives
Herbal appetite suppressors, fat and starch blockers

112
Q

reflexes assocaited dermatomes to check for back pain

A

reflexes:
patellar reflex–L4
Achilles reflex- S1

113
Q

what dermatomes / tests do you check w/ neck pain

A

Thumb/Index finger -C6
Middle finger- C7
Ring and Pinkie -C8

*spurling test and symptoms

114
Q

Sustained weight loss of ___% produces clinical meaningful health benefits and greater loss produces greater benefit for adults

A

3-5%

115
Q

edematous malnutrition with body weight 60 - 80% median for age; typically associated with hypoalbuminemia

A

Kwashiorkor

116
Q

transforaminal epidural steroid injection is used for waht type of back pain

A
  • Discogenic pain

- Radiculopathy

117
Q

how do you test for peripheral nerve entrapment of the median nerve?

A

Phalen’s Test

Tinel’s Test

118
Q

screen smoking men for AAA btwn what ages

A

65-75

119
Q

what Grade?
-the USPSTF has concluded that there is at least moderate certainty the harms of doing
the intervention equal or outweigh the benefits in the target population

A

Grade D

120
Q

derm. comorbidities associated w/ childhood obesity

A

acanthosis nigrican
intertrigo//furunculosis/panniculitis
hydradenitis suppurative

121
Q

describe a good sleep environment for a baby

A
  1. firm mattress
  2. fitted sheet ONLY (no pillows, comforters, or bumper pads)
  3. No drop-down crib rails–> entrapment and suffocation
  4. no adult bed–> entrapment and suffocation
  5. away from cords (strangulation)
  6. consider pacifier

*Car seats, strollers, swings, carriers, slings –> NOT recommended for routine sleep

122
Q

___is the best predictor of weight loss maintenance

A

physical activity

123
Q

when do you consider an MRI for back pain

A
  • listhesis is present on xray
  • evaluate soft tissue, disks, nerves, facet joints
  • red flags present
  • Radiculopathy with acute neurological findings
124
Q

higher prevalence groups of obesity in children

A
  • older children and adolescents
  • NA, black, latino
  • low socioeconmic status
  • maternal education is most imporatnt SES predictor of childhood obesity worldwide
125
Q

what should you try to calm a baby?

A

check for hunger, wet diaper, fever, burp

126
Q

describe the 2 types of CRPS

A

Type I: No evidence of nerve injury
-Hand surgery

Type II: Evidence of nerve injury
-Obvious injury to limb

127
Q
  • “obese” correlates with what percentiles
  • “overweight” correlates with what percentiles
  • “underweight” correlates with what percentiles
  • “Severely overweight” correlates with what percentiles
A

obese: over 95th%tile
overweight: 85-95th%tile
underweight: less than 5th%tile

severely overweight: over 99th%tile / over BMI 35**Comorbidities (4% of population)

128
Q

Depressive illness in the older population is a common and serious health concern that is associated with:

A

comorbidity,
impaired functioning,
excessive use of health care resources,
increased mortality (including suicide, double that of the general population)

129
Q

sx: cold intolerance, decline in
school performance, coarse
features, thin hair
-poor linear growth

A

hypothyroidism

130
Q

child obesity is greatest in what ethnicitys/races

A

Mexican americans
Non-hispanic blacks
non-hispanic whites

131
Q

control of car intake helps with what 4 things

A

weight control
blood sugar regulation
lower TGs
reduction in cavities

132
Q

unintentional geriatrci weight loss is considered what

A

more than 10lbs in 6 months

133
Q

Colorado Law:
Forward-facing with a ___ until they are at least ____

-Forward facing car seat if __ AND ___

A

Forward-Facing with a 5 point harness until they are at least 40 lbs

-If older than 1 year AND greater than 20 lbs

134
Q

recommendations for breast CA screening

A
  • reasonable every 1-2 yrs from 50-74y/o

- self exams are reasonable

135
Q

what happens to liver fxn w/ age?

A
  • Liver mass decreases between 20 and 40 percent with age

- Reduction of LDL metabolism and higher serum levels of LDL

136
Q

Back Seat of Car

Until ___ or ____

A

Back Seat of Car

Until age 13 or 100 lbs

137
Q

grades from the USPSTF

A

A, B, C, D, I

from best to worst

138
Q

preventative medicine for geriatrics

A
  • Ca and VitD for ALL at fall risk

- ASA for men 45-79w/ risk and women 55-79

139
Q
  • Peripheral nerve injury causing a CNS response
  • Activation of the sympathetic NS leading to a peripheral nerve response
  • Emotional triggers cause catecholamine release activating sympathetic nervous system
A

CRPS (complex regional pain syndrome)

*formally called RSD

140
Q

crying peaks at __ age

A

2 months of age and tends to be worse in evenings

141
Q

enroll child in swim lessons btwn what ages>

A

1-4 yrs of age

*avoid floaties or water wings –> use life jacket

142
Q

sleep promblems w/ geriatrics are often caused by

A 
psychiatric or medical condition: depression, 
OSA, 
urinary problems, 
pain, 
medications, 
COPD, 
GERD, 
neurological disorders
143
Q

what should the sleep position be?

A

supine (reduces SIDS risk by 50%)

  • prone and side are SIDS risk factor up to 1 year of age
144
Q

A _____ is one that is controlled by a single locus in an inheritance pattern

A

A Mendelian trait is one that is controlled by a single locus in an inheritance pattern
(single gene)

145
Q

T/F: Patients not meeting NLST criteria will get equal benefit from LDCT

A

False

*Persons who do not meet the minimum eligibility criteria for the NLST may have less net benefit

146
Q 
Severe obesity,
restrictive lung
disease,
may lead to right heart
failure, hypoxemic
respiratory drive
A

obesity hypoventilation syndrome

147
Q

what PE do u do when someone presents w/ pain neck pain w/ lateral rotation-facet mediated

A

facet loading

148
Q

____: assess the likelihood of the presence of a disease or condition in apparently healthy or ASYMPTOMATIC individuals who are at sufficient risk for a condition to benefit from further investigation or preventive action.

A

Screening: assess the likelihood of the presence of a disease or condition in apparently healthy or asymptomatic individuals who are at sufficient risk for a condition to benefit from further investigation or preventive action.

149
Q

___% of older people are infected with H. pylori

A

over 50%

150
Q

how much of the worlds population is geriatrics

A

over 2 billion worldwide or 20% of the world’s population

151
Q

what PE do you do w/ someone w/ pain with twisting, hurts to move from sitting to standing
(pain w/ lateral rotation- facet mediated)

A

facet loading

152
Q

to dx CRPS you need the sx of __ and 1 symptom in what 4 categories

A
  1. Sensory (Hyperesthesia -increased sensitivity to sensory stimulus), hyperalgesia, allodynia
  2. Vasomotor changes (temp abnormalities, skin color changes, skin appearance changes)
  3. Sudomotor changes (fluid retention, edema, sweating abnormalities, hair pattern changes
  4. Motor changes (stiffness, decreased ROM, weakness, tremor)
153
Q

what adult races/ethnicities have the highers prevalence of obesity

A

blacks
hispanics
whites

154
Q

how much physical activity should everyone have per day

A

60 min of moderate exercise

*sedentary time less than 2 hrs

155
Q

where should smoke detectors and CO detectors be placed?

A

smoke detectors- in every room

-CO- near bedrooms

156
Q

successful weight loss is defined by what?

A

5% or more reduction in baseline weight at 1+ yr f/u of initial treatment

157
Q

____: proportion of people with a positive test result who have the target disorder

A

Positive Predictive Value: proportion of people with a positive test result who have the target disorder

158
Q

___ : all the DNA (the genome)
___: all the coding DNA (the exons)
___: all the proteins
____: all metabolites

A
  • Genomics: all the DNA (the genome)
  • Exomics: all the coding DNA (the exons)
  • Proteomics: all the proteins
  • Metabolomics: all metabolites
159
Q

Motor exams w/ associated dermatomes to assess back pain

A

Tibialis anterior- foot dorsiflexion–L4

Extensor Hallucis longus–Big toe dorsiflexion– L5

Peroneus longus/brevis
External rotation of foot/5th toe–S1

160
Q

when to get an xray w/ back pain

A
  • not improving w/initial tx
  • suspect vertebral fracture
  • hx of fusion
  • spinal instability (flexion/extension views)
161
Q

6 types of dementia

A
  • Alzheimers (60-80%),
  • Dementia with Lewy Bodies,
  • Frontotemporal,
  • Vascular,
  • Parkinson’s,
  • Etoh related
162
Q

Which screening tools have been shown in AN RCT to decrease risk of dying from colon cancer?

A

sigmoidoscopy

gFOBT (guaiac)

163
Q

a pedigree contains what type of information?

A

-contains biological, social, and psychosocial information

164
Q

what are the 5 vulnerable periods for weight gain?

A
  • infant “catchup” weight gain
  • childhood/puberty/adolescence
  • adulthood
  • gestational weight gain
  • menopause
165
Q

what happens to kidney fxn w/ age?

A
  • Renal mass decreases by 25 to 30 percent between the ages of 30 and 80 years, with the steepest decline after age 50.
  • Creatinine clearance decreases with age (7.5 to 10 mL per minute per decade)
  • ALL renal related functions diminish with time and nephrotoxicity related to medications, IV contrast, dehydration, and UTIs are common
166
Q

normal sleep changes w/ geriatrics

A

– older adults take longer to fall asleep and have more
nighttime wakefulness and more daytime napping
– An earlier bedtime and wake time are common

167
Q

orthopedic comorbidities associated w/ childhood obesity

A
  • slipped capital femoral epiphysis (More likely to progress to bilateral disease in obese)
  • Blounts disease
168
Q

Sciatic nerve pain rarely goes beyond what

A

the knee

169
Q

interventional therapies for CRPS:
____ blocks for upper extremity symptoms
____ blocks for lower extremity symptoms

A

Cervical ganglion blocks for upper extremity symptoms

Lumbar sympathetic blocks for lower extremity symptoms

170
Q

leading cause of death for children over 3

A

Motor vehicle crashes

5000 children and adolescents die in crashes

171
Q

sx: Dyspnea, edema,

somnolence

A

obesity hypoventilation syndrome

172
Q

the goal of healthy people 2020 was to increase prevalence of healthy weight among adults to __% and reduce the prevalence of obestiy among adults to __%

A

34%

less than 30%

173
Q

presents w/

  • Symmetric Flaccid Paralysis
  • Absent Achilles reflex bilaterally
  • Absent anal reflex
  • numbness and tingling in groin
A

Cauda equina syndrome

*surgical emergency

174
Q

10 components of geriatric assessment

A

1) Functional status
2) Fall Prevention
3) Nutrition
4) Vision
5) Hearing
6) Depression
7) Insomnia
8) Advanced Care Preferences
9) Cognition
10) Polypharmacy

175
Q

Limit internet time to __ hours/day

A

Limit internet time to 2 hours/day

176
Q

what reflexes and associated dermatomes do you check w/ neck pain?

A

biceps relfex –C5
Brachioradialis reflex– C6
Triceps reflex –C7

177
Q

dermatomes on feet to check for back apin

A

Big toe–L4
2nd, 3rd, and 4th toes— L5
little toe/lateral foot S1

178
Q

how to assess adequate intake for babies

A

-Maximum weight loss after birth =/less than 7% birth weight
-Rate weight gain (~30 g/d x 1-2 mo)
-Voiding: 6-8 “wet” diapers/d; urine should be dilute, clear; urate crystals = sign of dehydration/ inadequate intake
Stooling: “milk stools” by ~3 d; stool ~q feed; mustard/cottage cheese; after 5-6 wk may stool less frequently than formula fed infant;

179
Q

what are traditional risk factors for obesity in adults

A
  • HTN
  • glucose intolerace/DM2
  • dyslipidemia
  • waist circumference
180
Q

what vision problems come w/ age

A

cataracts
glaucoma
macular degeneration
abnormalites w/ accommodation

181
Q

all children ____ years must be in a child restraint system

A

under 8

  • must be in the rear seat of the vehicle
  • use tether system and LATCH whenever possible
182
Q

how do you test for peripheral nerve entrapment of the ulnar nerve?

A

Cubital Tunnel Test

Tinel’s at medial aspect of elbow

183
Q

geriatric poor nutrition may reflect what

A

medical illness
depression
functional losses
financial hardship

(MEALS ON WHEELS)
meds, emotional problems, anorexia, late-life paranoia/alcoholism, swallowing disorder, oral factors, no money, wandering, hyperthyroidism/hyperparathyroidism, entry problems/malabsorption, eating problems, low salt/cholesterol, shopping/food prepareness

184
Q

The prevalence of dementia doubles every 5yrs starting at age __ approaching 50% by age ___

A

65

90

185
Q

sx: bowed legs +/- knee pain
potentially disabling (genu varum)
-stress injury to medial tibial growth plate, often painless

A

-Blounts disease

186
Q

motor exams/dermatomes for neck pain

A
  • Deltoid/Biceps (C5)
  • Biceps and Extensor carpi radialis longus and brevis (C6)–Wrist Extension
  • Triceps, wrist flexors, and finger extensors (C7)
  • Finger flexors, and interossei muscles (C8)–Spreading fingers apart
187
Q

describe what happens w/ Ca reabsorption and colonic motility with age

A

-calcium absorption from the gut lumen decreases
( Typically, women over age 75 absorb 25 percent less of a given dose of calcium than younger women)

-colonic propulsive motility is reduced with age and about one-fourth of those over 65 years suffer from chronic constipation

188
Q

How has mortality changed since screening for breast CA

A

Mortality has decreased by about 30% since screening began

189
Q

T/F: detecting cancer early proves that cancer screening saves lifes

A

False- it only proves that you detected it early

190
Q

Requirements of a successful screening program

A
  1. Screening advances time of diagnosis of cancers destined to cause trouble
  2. Early treatment is superior to treatment started after patient already has symptoms
191
Q

Leading cause of recreational sports injury

A

bicycles
*Bicycle helmets can prevent ~88% of serious brain injuries

*Colorado does not have a statewide requirement for bicycle helmets for children

192
Q

main sleep issues

A
  1. suffocation
  2. asphyxia due to entrapment
  3. co-sleeping
193
Q

atherosclerotic risks in obese children

A

fatty streaks
plauqe in coronaries
HTN
hyperlipidemia

194
Q

fat should be ___% of daily intake of calories

A

20-35%

-less than 10% from saturated fat

195
Q

future approaches of PM and R

A
  • stem cell therapy

- platelet rich plamsa (PRP)

196
Q

what tests do you do w/ someone w/ pain sititng, usually better w/ walking
(SI Joint pain)

A
  • Patrick’s test/Faber
  • Fortin Finger test (Tenderness just inside of the posterior superior iliac spines, Hip exam)
  • palpate ASIS
197
Q

____: proportion of a defined group of people who have a condition or disease at a given point in time
___: proportion of an initially disease-free group of people who develop the disease over a given period

A

Prevalence: proportion of a defined group of people who have a condition or disease at a given point in time

Incidence: proportion of an initially disease-free group of people who develop the disease over a given period

*Tracking prevalence and incidence over time can help to determine health care strategies aimed at limiting the burden of a disease

198
Q 
A new functional decline and loss of independence in one of the following:
•  Learning and memory
•  Language
•  Executive function
•  Complex attention
•  Perceptual-motor function
•  Social cognition
A

dementia

199
Q

-the entire set of genetic

instructions found in a cell

A

genome

200
Q

5 Most effective behavioral therapy for adult weight loss

A
  • Self-monitoring
  • Assessing readiness to change
  • Structured meal plans, meal replacements and portion control
  • Goal setting
  • Problem solving
201
Q

what imaging could you get for CRPS if done early?

A

3 phase bone scan

202
Q
  • less than 4 weeks onset

- In the absence of neurologic deficits and red flags conservative treatment is warranted

A

acute back pain

203
Q

carbs should be ___% of daily intake of calories

A

45-65%

*no more than 100-150 calories a day from added sugar

204
Q

use CDC BMI (kg/m2) charts for what age?

and why?

A

2-20 yrs

  • reflects weight relative to linear growth
  • correlation w/ EXCESS ADIPOSITY in children
205
Q

sx: Polyuria and polydipsia,

unintentional weight loss

A

-DM2

206
Q

Screen all adults born between 1945‐1965 one time for ___

A

hep C

207
Q

what happens to esophageal contractions w/ age?

A

decreases

-combined with decreased lower esophageal sphincter tone, results in increased gastric acid exposure – ie more GERD

208
Q

Measurable impairment in one of the cognitive domains with preservation of independence and function

A

mild cognitive impairment (MCI)

209
Q

Booster Seat OR Car Seat
Children ____ years of age
-Booster utilizes lap and shoulder belt

A

Booster Seat OR Car Seat
Children 4-8 years of age

  • through their 8th birthday
  • $80 fine
210
Q

hearing problems w/ age

A
  • hearing loss is common–> lead to social withdrawl
  • check cerumen impaction

*Senile hearing loss is usually bilateral and in the high frequency range

211
Q

What are the components of health maintenance visits?

A
  • Screen for diseases
  • Assess risk of future medical problems
  • Encourage a healthy lifestyle
  • Update vaccinations
  • Maintain a relationship with a health care provider in case of an illness
212
Q

___: proportion of people with a negative test result who are free of the target disorder

A

Negative Predictive Value: proportion of people with a negative test result who are free of the target disorder

213
Q

who should be referred to bariatric surgery?

A
  • Adults with BMI at or above 40
  • BMI at or above 35 with obesity-related comorbidities
  • Individuals who have not responded to other treatment
214
Q

leading cause of death among children over 1 year

A

unintentional injury

-falls, burns, firearms, sports

215
Q

geriatric vaccination recommendations

A
  • annual flu (not live)
  • Td booster every 10 yrs
  • pneumococcal 1x over 65
  • herpes zoster 1x over 60 (regardless if had chickenpox or shingles)
216
Q

Screening ___ for lung cancer is the most beneficial cancer screening test we have – when applied to high risk patients

A

Screening LDCT (low dose chest CT) for lung cancer is the most beneficial cancer screening test we have – when applied to high risk patients

217
Q

How has mortality changed since screening for CRC

A

-Declines in both incidence and mortality since the introduction of CRC screening

*this is quite different than what has been
observed with breast and prostate CA screening

218
Q

screen what aged women for osteoporosis

A

over 65 or at high risk using BMD

219
Q

set water temp to what?

A

less than 120F

220
Q

what pulmonary conditions are common in children who are obese

A

obstructive sleep apnea

obesity hypoventilation syndrome

221
Q

Once patients are in their ____, consider backing off of common preventive medications and screenings

A

mid 70’s-80s

222
Q

leading cause of death (1-21yrs)

A

intentional injury

  • homicide
  • suicide
223
Q

leading causes of death among older adults

A
  • heart disease
  • CA
  • stroke
224
Q

what ages are eligible for medicare?

A

65+

225
Q

___ is most imporatnt SES predictor of childhood obesity worldwide

A

maternal education

226
Q

___: impact of the disease on health and functioning
___: the degree to which a condition results in death

A

Morbidity: impact of the disease on health and functioning

Mortality: the degree to which a condition results in death

*prevention reduces morbidity and mortality

227
Q

For every increase of 5 kg in adults the relative risk of what 3 things go up?

A

CHD (14%)
Stroke (4%)
Ischemic Stroke (16%)

228
Q

do these supplements have evidence to help with weight loss

  • Garcinia
  • Glycerol
  • Guar gum
  • Inulin
A

possibly inneffective

229
Q

Lifetime prevalence of low back pain is ____%
__ most common cause of primary care office visits
___most common cause of all physician visits

A

85%

2nd

5th

230
Q

depression screening tools

A

PHQ2
PHQ9
GDS15
CSDD- for dementia w/ suspected depression

231
Q

geriatrics w/ BP over/= ____ should be screen for DM

A

135/80

232
Q

therapeutic approach to treating conditions/symptoms through a specifically tailored diet

A

medical nutrition therapy (MNT)

233
Q

what type of prevention:

interventions that reduce the risk of disease occurrence in otherwise healthy individuals.

A

primary prevention

234
Q

sun safety for children less than 6 months?

A
  • Dress in lightweight long-sleeved and pants
  • Wide brimmed hat
  • If no shade –> SPF 15
235
Q

what happens to the pulsatile secretion of gonadotropins, growth hormone, thyrotropin, melatonin, and adrenocorticotropic hormone (ACTH) with age

A

attenuated /lessened

236
Q

do these supplements have evidence to help with weight loss

  • Caffeine
  • Calcium (diet)
  • Conjugated linoleic acid
  • Diacylglycerol
  • Ephedra (banned in US)
  • Fish oil
  • Vitamin D (obese deficiency)
A

possibly effective

237
Q

consider screening patients on SSRIs for ___, possibly lower max dose of citalopram/ escitalopram

A

hyponatremia

238
Q

Acute pain ___ weeks

Chronic pain ___ months

A

Acute pain: less than 2 weeks

Chronic pain: more than 6 months

239
Q

___: the proportion of people with the target disorder who have a positive test result

A

Sensitivity: the proportion of people with the target disorder who have a positive test result

240
Q

neurologic comorbidies associated w/ childhood obesity

A

Psuedotumor Cerebri

Prevention Across the Lifespan (2 decks)

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