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Family Medicine > Health Maintenance (Dr. Omori's Handout) > Flashcards

Health Maintenance (Dr. Omori's Handout) Flashcards

1
Q

Folate supplementation recommendations

A
  • 4 mg/day 1-3 months prior to conception for previous h/o NTD
  • .4 - .8 mg/day 1 month prior to conception for planned pregnancies
  • .4 mg/day for all women of child bearing age
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2
Q

This is the reason that we give progestins to women receiving hormone replacement therapy.

A

Prevention of endometrial cancer

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3
Q

The WHI and HERS studies showed increased risks of ________________ in those taking combination therapy

A

breast CA, coronary artery disease (mainly non-fatal MI), stroke, and venous thromboembolism

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4
Q

HRT indications

A

HRT should not be used for the primary or secondary prevention of any diseases (i.e. coronary disease, osteoporosis, dementia)…it should only be considered for short-term use for the control of menopausal symptoms

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5
Q

Women should be counseled that many of the “Natural” menopause supplements that are available contain phytoestrogens, which carry ____ risk compared to synthetic estrogen

A

Same

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6
Q

Age at which we start giving children fluoride in the state of Hawaii

A

Start at 6 months

Also recommended that PCPs apply fluoride varnish to all primary teeth at age of primary tooth eruption

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7
Q

This is the group of patients in whom primary prevention with aspirin prophylaxis is recommended by the USPSTF

A

The USPSTF recommends the use of aspirin for the primary prevention of cardiovascular disease (CVD) and colorectal cancer (CRC) in adults aged 50-59 who have a 10% or greater 10-year CVD risk, are not at increased risk for bleeding, have a life expectancy of at least 10 years, and are willing to take low-dose aspirin daily for at least 10 years.

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8
Q

What is the current recommendation for daily intake of calcium for a post-menopausal woman?

A

1200 mg

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9
Q

Who should be screened for osteoporosis?

A

All women 65 years and older should receive bone density screening for osteoporosis.
Women age 60-64 should receive screening if they are at increased risk for osteoporotic fractures.

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10
Q

This is the screening tool that is recommended for detecting colon cancer in average risk individuals.

A
  • FOBT yearly or, Flexible Sigmoidoscopy every 3-5 years or, Colonoscopy every 10 years
  • Screening begins at age 50 for all normal risk individuals and go until age 75; starts at age 40 for high risk individuals.
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11
Q

According to the USPSTF, this is when women should start getting pap smears and at this frequency.

A
  • The USPSTF recommends screening for cervical cancer in women ages 21-65 years with pap smears every 3 years (Grade A recommendation)
  • For women 30-65 who want to lengthen the screening interval to every 5 years, you can combine pap smears with Human Papillomavirus (HPV) testing.
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12
Q

Routine visual acuity screening is recommended by the USPSTF for this group of patients

A

• The USPSTF recommends visual acuity screening for all children at least once between the ages of 3 – 5 years, to detect amblyopia or its risk factors

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13
Q

Screening for this infectious disease is recommended for all individuals aged 15-65.

A

• The USPSTF recommends that clinicians screen for HIV infection in adolescents and adults ages
15 to 65 years. Younger adolescents and older adults who are at increased risk should also be
screened. (Grade A)
• The USPSTF recommends that clinicians screen all pregnant women for HIV, including those
who present in labor who are untested and whose HIV status is unknown. (Grade A)

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14
Q

This is the most important way we screen for coronary artery disease in an asymptomatic patient.

A

• Assessing for risk factors (History taking)

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15
Q

According to the USPSTF, this is the age at which women should start being screened with mammograms.

A

The USPSTF recommends biennial screening mammography for women aged 50-74 (Grade B recommendation)

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16
Q

According to the USPSTF, screening for hypercholesterolemia should be started at what age for women?

A
  • Women: ages 45 – 65 (Grade A recommendation)

* > 20 years of age if they are at increased risk for coronary heart disease

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17
Q

According to the USPSTF, screening for hypercholesterolemia should be started at what age for men?

A
  • Men: ages 35 – 65

* > 20 years of age if they are at increased risk for coronary heart disease

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18
Q

Screening interval for hypercholesterolemia in an asymptomatic patient

A

5 years

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19
Q

Screening test for hypercholesterolemia

A

Total cholesterol followed by fasting lipid panel if total is elevated

20
Q

According to the USPSTF, who should be screened for diabetes mellitus, type II (other than during pregnancy)

A

• The USPSTF recommends screening for type 2 diabetes adults age 40-70 who are overweight or obese; every 3 years.

21
Q

According to the USPSTF, this is when Chest x-rays should be used for screening purposes.

A

NEVER

22
Q

This/These lab tests would be appropriate for screening in an asymptomatic 57 year old male.

A

• Serum Cholesterol, HIV, Hepatitis C, and Fecal Occult Blood Testing (unless other colon cancer screening chosen)

23
Q

There is sufficient evidence to recommend screening and behavioral counseling interventions for this non-tobacco related, addictive problem in all adults.

A

Alcoholism

24
Q

Counseling elderly patients on exercise, environmental hazard reduction, and close monitoring of their
medications has been shown to decrease this.

A

• Falls

25
Q

The USPSTF recommends ______ & _____ to prevent falls in community-dwelling adults aged 65 years or older who are at increased risk for falls

A

exercise or physical therapy and vitamin D supplementation

26
Q

These are 4 of the safety issues you should counsel parents of small children about

A

Fires
Burns
Poisoning
Injury

27
Q

What are the recommendations for car restraints for children?

A
  • A semi-upright/forward facing child seat is indicated for all children above 2 years of age that weigh < 40 lbs.
  • Infants < 2 years old should be placed in a rear-facing safety seat in the back seat
  • Children over 40 lb should be placed in booster seats until they can safely fit in a vehicle safety
    belt (usually until age 8 – 12 or 4’9”) or a seatbelt height adjuster is used
  • All children under 13 years old should sit in the backseat of the car
28
Q

These are the hours of the day that people should avoid sun exposure to reduce their risk of skin cancer in Hawaii.

A
  • 10:00 am – 4:00 pm
29
Q

The USPSTF recommends counseling children, adolescents, and young adults aged _____ who
have fair skin about minimizing their exposure to UV radiation to reduce their risk for skin
cancer

A

10-24

30
Q

Adults should get this vaccine every 10 years or in some cases within 5 years of their last shot.

A
  • Tetanus-diphtheria
  • Newest recommendation is that adults get at least one dose of Tdap (new safe formulation of
    tetanus, diphtheria, acelluar pertussis) and then follow with Td.
  • All pregnant women should get a Tdap during each pregnancy, regardless of the interval since
    prior vaccine.
31
Q

What is the DTap immunization schedule for children?

A

2 mos, 4 mos, 6 mos, 15-18 mos, and 4-5 years.

32
Q

When is tetanus Ig indicated?

A

Incompletely vaccinated patients (did not receive

first three shots in series) with deep or contaminated wounds

33
Q

Pregnant women who will be in their 2nd or 3rd trimester during the winter season should receive this
vaccination.

A

Influenza (killed vaccine)

34
Q

Children 6 mos-9 years who are receiving the influenza vaccine for the first time need _______.

A

One booster > 4

weeks after initial vaccine

35
Q

This is the reason why we now use the subcutaneous rather than the oral vaccinations for polio.

A

To decrease the incidence of vaccine induced polio

36
Q

What is the IPV immunization schedule for children?

A

2 mos, 4 mos, 6-18 mos, and 4-6 years

37
Q

Immunization with Hib vaccine is meant to prevent what type of illnesses in specific.

A

Invasive infections with Haemophilus influenza – i.e. meningitis and epiglottitis

38
Q

What is the Hib vaccination schedule for children?

A

Primary series is: 2, 4, and 6 mos

If PRP-OMP (PedvaxHib or Comvax) given at 2 and 4 mos, don’t need at 6 mos

One booster dose at 12-15 mos.

39
Q

These are three of the main groups of people who are candidates for pneumococcal vaccine.

A
  • All children under age 5 (Pneumococcal Conjugate Vaccine - Prevnar)
  • All adult smokers (Pneumovax) – more than half of all serious invasive pneumococcal infections
    occur in smokers
  • Adults and children over 2 at high risk (Pneumococcal Polysaccharide Vaccine – Pneumovax)
    – Diabetes, cardiovascular and chronic pulmonary disease
    – High risk of pneumococcal disease: splenic dysfunction or anatomic asplenia, Hodgkin’s
    disease, multiple myeloma, chronic liver disease, including cirrhosis, alcoholism, renal
    failure, cerebrospinal fluid leaks, and immunocompromised state
  • Residents of nursing homes or long-term care facilities
  • Healthy elderly 65 years old and above
40
Q

USPSTF recommends a one time ______ in men ages 65-75 who have ever smoked, to screen for _______.

A

abdominal ultrasound; abdominal aortic aneurysm

41
Q

The USPSTF recommends screening for _______ in the general adult population, including pregnant and postpartum women.

A

depression

42
Q

The USPSTF recommends screening for __________ for all sexually active young women aged 24 and younger and for older women who are at increased risk.

A

gonorrhea and chlamydial infection

43
Q

TB test induration of >5 mm is positive for these groups.

A
  • HIV positive individuals
  • Recent contacts of TB case
  • Persons with fibrotic changes on CXR consistent with old healed TB
  • Patients with organ transplants and other immunosuppressed patients (receiving
    the equivalent of > 15 mg/day of prednisone for > 1 month)
44
Q

TB test induration of >10 mm is positive for these groups.

A
  • Recent arrivals (<5 years) from high-prevalence countries
  • Injection drug users
  • Residents and employees of high-risk congregate settings: prisons, nursing
    homes, hospitals, residential facilities for AIDS patients, and homeless shelters
  • Mycobacteriology lab personnel
  • Children < 4 years of age, or children and adolescents exposed to adults in high
    risk categories
  • Those w/ previous BCG vaccine
  • Everyone in Hawaii
45
Q

> 15 mm of induration is classified as positive in what groups of people?

A

Persons with no known risk factors for TB

Family Medicine (3 decks)

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