Health Planning Flashcards
Primary Prevention
intend to avoid disease development
ex. aspirin, give to pt w/o heart disease to prevent stroke or MI
Secondary Prevention
attempt to diagnose and treat an already existing disease in early stages and possibly cure it.
ex. once they’ve had a stroke we give them aspirin
Tertiary Prevention
treatments aim to slow disease prevention
ex. end stage CHF, medications given to make them feel better and prolong life, slow progression of disease
Top 10 causes of death in US (order)
Heart Disease Cancer COPD Unintentional Injuries Stroke Alzheimers Disease Diabetes Mellitus Influenza & Pneumonia Renal Disease Suicide
RISE what is it and why do we do it?
Done on yearly exams; preventative visit
R- risk assessment (heart disease, cancer, HIV, depression, etc.)
I- Immunizations dont forget about adults
S- Screening Tests
E- Education/counseling
-dental health, nurtition, exercise, weight management, injury prevention, contraception, mental health, etc.
Tools for preventative Health
- education
ex. breast and testicular exams, limit sun exposure, seat belts - screening
ex. blood pressure, diabettes, Breast colon and prostate cancer
3 main categories of risk factors for disease
Genes, behaviors, environment
You can protect your health by altering your….
environment and behaviors
Knowing Family History helps w/ disease prevention by…
early prevention, early screening, and aggressive treatment
Risk factors for DM
- family history
- BMI >25
- Race/Ethnicity (African-A, Native-A, Hispanic-A, Pacific islander-A, Asian-A
- Age >45
- HTN (>140/90)
- HDL Cholesterol 250
- History of GDM (gestational)
- Hx of Macrosomia (birth to baby >10lbs
- Polycystic Ovarian Disease
- Previous Abnormal Screening
- Physically inactive
- Vascular Disease
DM Screening recommendations
- BMI >/=25 + one or more risk factors
- no risk factors and >45yo
depending on results screen q3yrs
Diabetes Screening Tests
A1C- measures amount of sugar that has attached to RBC, gives average of whats been going on past 3 mo.
*Normal /= 6.5%
Fasting Plasma Glucose (FPG)
*normal /= 100
Diabetes >/= 126
Oral glucose tolerance test
- normal /= 140
- diabetes >/= 200
Retesting DM
if results normal and no risk factors retest 3yrs
results normal + risk factor retest 1 year
results indicate per-diabeties retest yearly
Heart Disease Risk Factors
- Atherosclerosis
- diabetes
- chronic kidney disease
- hyperlipidemia
- hypertension
- smoking
- overweight
- excessive alcohol intake
- sedentary lifestyle
- advanced aging
- diet high in sat fat, sugar and low in fruits and vegetables
- abdominal obesity
Primary prevention for Heart disease?
ASPIRIN
men 45-79 heart attacks
women 55-79 ischemic stroke
Aspirin for primary prevention of Heart Disease may be changing….What types of factors would go into this decision making?
Bleeding disorders, asprin allergy, clotting disorders, old age, etc is when the risks outweigh the benefits of asprin.
Elderly are at greater risk for GI bleeds w/ asprin
HTN leads to…(4)
Premature death
Heart Attack
Stroke
Chronic Kidney disease
Hypertension BP #
150(140)/90
2 or more readings at least a week apart
**Can diagnose based upon diastolic or systolic alone.
Hypertension Treatment
- Lifestyle changes: decrease Na intake, etoh, increase K+, increase physical activity, weight loss, stress management, treatment of sleep apnea
- Medications
Screening Lipid Disorders
Routinely Screen men 35yo women 45yo
Routinely screen men 20-35 & women 20-45 if other risk factors present
screen q5yr? upper age 65?
Leading Cause of preventable and premature death?
Tobacco Use
Calculate # Pack Years
packs/day*(#yrs smoked)
*always round up w/ packs
Tobacco Cessation Treatment
- gradual scheduled decrease
- nicotine replacement
- medications
- cessation programs, support groups
CAGE questionnaire
& Scoring
used for alcoholism
C- ever felt you should CUT DOWN on drinking?
A- have people ANNOYED you by criticizing your drinking?
G- have you felt GUILTY about your drinking?
E- have you ever had drink 1st thing in AM to steady nerves/get rid of hangover (EYE-OPENER)
Scoring: each answer YES = 1 point
* >2 excessive drinking and alcoholism
6 Reasons for Sexual Hx
- identify need for infection screening
- assess risk of infection
- assess risk of transmission of infection
- assess risk of pregnancy
- educate about sexual health
- identify which clinical specimens need to be obtained
How often should breast and testicular exams be performed? Starting at what age?
Monthly for both sexes.
Age 20 Women
Age 15 Men
3 types of skin cancer
basal cell
squamous cell
melanoma- main cause is too much UV ray exposure
Osteoporosis Risk Factors
Age, female, caucasian, low body weight, bilateral oophorectomy
At what age do we screen Osteoporosis?
Women >/= 65
Men >/= 70
Screen younger if risk factors
Breast Cancer
- when do we screen?
- what counseling/tests performed?
women +20yo
- Self Breast Exam
- Clinician Breast Exam
- mammogram @ 40yo if no risk factors
Colorectal Cancer
- when do we screen?
- what counseling/tests performed?
Men and women +50yo
- Fecal occult blood test
- Flexible sigmoidoscopy
- Double Contrast Barium Enema
- Colonoscopy
- CT colonography
Endometrial Cancer
- when do we screen?
- what counseling/tests performed?
Women at menopause
-counseling to report unusual symptoms of bleeding
Lung Cancer
- when do we screen?
- what counseling/tests performed?
current/former smokers 55-80 in good health w/ at least 30pack year hx
low dose helical CT
- Stop screening once 15y from quitting smoking
Prostate Cancer
- when do we screen?
- what counseling/test performed?
Men 50+
Digital Rectal Examination
Prostate Specific Antigen
Cancer Related Check-up
- when do we screen?
- what counseling/test performed?
Men and Women 20y+
Exam of thyroid, testicles or ovaries, lymph nodes, oral cavity, skin.
Prevention counseling (tobacco, sun exposure, diet, nutrition, risk factors, sexual practices, environmental and occupational exposures.)
