General Health

Question 1

Patient adherence

Answer 1

Depends on behavioral changes; alterations in diet, exercise, smoking cessation, alcohol cessation, adherence to medication.
50% fail to do this.
1/3 never take their medication.
Do not seek care or drop out.
Insurance concerns (high pay deductible
Patients will take medication, but they wont diet, exercise, check their bs.
Short Term Regimens:
Give clear instructions, written and in simple text.
Long Term Regimens:
Teach back method
Simplify dosing
Convenient care, eliciting family/friends. Find the support structure.
Trust the provider!

Question 2

Preventative medicine ( primary, secondary, tertiarty)

Answer 2

Primary Prevention
Remove or reduce disease risk factors (e.g., immunizations, giving up or not smoking, seat belts).
Secondary Prevention
Promote early detection of disease (e.g., Pap smear, mammography, PSA).
Tertiary Prevention
Limiting the impact of established disease (e.g., Chemotherapy for cancer, ICS for Asthma).

Question 3

PREVENTIONOF ID

Answer 3

Immunizations: review at age 50.
Flu shots
Pneumovax. Reimmunizeat age 65 if they received immunization > 5 years ago.
Tetanus , Tdap.
Hepatitis B.
Hepatitis A.
HPV
PPD
NYS mandate to offer HIV Screening
Shingles vaccine (live virus, reduction of shingles by 51%)

Question 4

PREVENTIONOF CARDIOVASCULAR DISEASE

Answer 4

Modifiable (BP, Lipids, smoking)
Non modifiable (age, gender, family hx).
Specifics in the sections to be covered.

Question 5

PREVENTIONOF OSTEOPOROSIS

Answer 5

Primary prevention includes; calcium, Vitamin D, weight bearing exercise.
Mineral Density for women over age 60.
Bisphosphonates

Question 6

PHYSICAL INACTIVITY

Answer 6

The second most important contributor to preventable death. Follows smoking cessation.
30 minutes of moderate physical activity most days of the week.
The 5 A’s: Ask, Assess, Advise, Assist, Arrange.

Question 7

PREVENTION OF OVERWEIGHT AND OBESITY

Answer 7

Record BMI.
Lifestyle modification: exercise, diet, behavior therapy.
Low fat, high vegetable, fruits, grains.
Consider mediterraneanand low carbdiet.
Bariatric Surgery.

Question 8

CANCER PREVENTION

Answer 8

Primary Prevention: sunscreen, prevention of cigarette smoking, Hepatitis B
Screening and early detection through pap smear, mammography, PSA.

Question 9

PREVENTION OF INJURIES AND VIOLENCE

Answer 9

Homicide and Motor Vehicle Accidents still the major cause of injury related deaths.
Seat belts, Avoid Drinking and driving.
Physical and Sexual Abuse assessments.

Question 10

PREVENTIONOFSUBSTANCEABUSE:ALCOHOL& ILLICITDRUGS

Answer 10

CAGE Screening (Cut down on drinking, Annoyed by criticism, Guilty, eye opener).