Health Maintenance

Question 1

What should be considered when a patient comes for a well visit?

Answer 1

Get a thorough history, social history, evaluate any risk factors based on lifestyle and family history

Question 2

What is a USPSTF recommendation?

Answer 2

recommendations of certain clinical preventative services put together by experts who make evidence based recommendations

Question 3

Importance of evidence based medicine

Answer 3

allows patient to have best outcomes and provides patient most effective care based on evidence available

Question 4

What is included in preventative services?

Answer 4

screening, immunizations, general health guidance, counseling to reduce risky behaviors

Question 5

What is primary prevention?

Answer 5

intervention to prevent disease, includes vaccine, diet counseling, tobacco counseling, etc.

Question 6

What is secondary prevention?

Answer 6

screening test for dz early while patient may still be asymptomatic or before dz onset (BP checks, labs, mammogram)

Question 7

What is tertiary prevention

Answer 7

Clinical intervention that prevents dz progression or reduces complications (BP meds, chemo, etc.)

Question 8

Grade A or B practice suggestion

Answer 8

provide service

Question 9

Grade C practice suggestion

Answer 9

offer or provide service depending on circumstances

Question 10

Grade D practice suggestion

Answer 10

Discourage use of service

Question 11

Importance of well visits

Answer 11

used to treat current medical conditions and provide preventative care to decrease future health deterioration

Question 12

Providing preventative services should be based on what three factors?

Answer 12

pt age, gender, risk factors

Question 13

Harms of screening

Answer 13

cost, anxiety, decreased benefits based on patient age or comorbidities

Question 14

Is there a guideline for checkups/well visits?

Answer 14

No!

Question 15

Clinical rule of thumb to consider checkups

Answer 15

Every 3 ys in pts <49 without chronic medical issues; Every year for pts > 50 without chronic medical issues

Question 16

How often should diabetic patients receive a check up?

Answer 16

Every 3 mo for A1C monitoring

Question 17

How often should patients with HTN receive a check up?

Answer 17

Every 3-6 mo depending on control of BP

Question 18

When to screen for Colon CA?

Answer 18

every 10 yrs at ages 50-75

Question 19

When to screen for lung CA?

Answer 19

CT 55-74 yr old with at least 30 py history

Question 20

When to screen for cervical CA?

Answer 20

Pap smear 21-65, frequency dependent on risk factors

Question 21

When to screen for breast CA?

Answer 21

mammogram 50-65

Question 22

What should be screened to asses for CVS risk?

Answer 22

diet, smoking, physical activity, hypertension, dyslipidemia, DM, obesity

Question 23

How often should a person get an influenza vaccine?

Answer 23

every year

Question 24

Frequency of Td/Tdap

Answer 24

every 10 years

Question 25

Frequency of HPV vaccine

Answer 25

vaccine series should be received before age 26

Question 26

Who should get a zoster vaccine?

Answer 26

Pts 50 years and older

Question 27

Who should get a pneumococal vaccine?

Answer 27

pts 19-64 at increased risk and all pts 65 and older

Question 28

Who should get a hep B vaccine?

Answer 28

65 yo and older with diabetes, anyone at increased risk