Health Promotion Flashcards
USPSTF grade A recommendation
high certainty of benefit
USPSTF grade B recommendation
recommends this service, high certainty of NET benefit
USPSTF grade C recommendation
Recommends selectively offering this service, net benefit is small
USPSTF grade D recommendation
Dont do it
USPSTF grade I recommendation
Inconclusive data
Definition of Obesity in adults
BMI > 25 is overweight
BMI > 30 is obese
Definition of Obesity in Pediatrics
Overweight = BMI at or above 85th percentile for same age and sex Obese = BMI at or above 95th percentil for children of same age and sex
What are the aerobic activity level recommendations for adults?
SOR C
Moderate activity 150 min/wk
Vigorous activity 75 min/wk
Even 10 minutes is beneficial
At what BMI should physicians refer adult pts to intensive multicomponent behavior interventions
> 30
B recommendation
At what age do you begin to screen kids for obesity
Age 6
B recommendation
Definition of heavy drinking
Women: more than 1 drink per day on average
Men: more than 2 drinks per day on average
Definition of binge drinking
Women: 4 or more during single episode
Men: 5 or more drinks during single episode
What are the two validated tools recommended by USPSTF to screen for alcohol abuse
CAGE and AUDIT
SOR A
What Audit score indicates strong likelihood of hazardous alcohol consumption. What score indicates dependence?
Hazardous consumption:
- men 8
- women 7
Dependence: 20
Definition of primary prevention
avoids development of a disease
Ex: immunizations
What gauge of needle reduces risk of adverse reaction to vaccinations?
25mm vs 16 mm
SOR A
If someone misses a vaccination does the series need to be restarted?
NO
Are antipyretics recommended for routine prophylaxis before immunizations?
NO
SOR A
Is breastfeeding a contrainditation to vaccines?
NO
Can you give both doses of meningitis vaccine on same day?
Yes, just use different sites
At what age should children with hx of sexual assault be vaccinated against HPV?
9
Which vaccines should wait until after pregnancy?
Varicella
MMR
HPV
Influenza LAV
What are the indications for PPSV 23 ONE dose from age 2-64?
- chronic cardiac disease
- liver disease
- DM
- cochlear implants, CSF leak
- Lung disease
- resident of chronic care institution
What are the indications for PPSV 23 TWO dose from age 2-64?
- Renal disease
- Asplenia/Sickle cell
- Immunocompromised
- give 3-5 years apart
When should PCV 13 be given?
> age 19 if
- Immunocompromised
- asplenia/sickle cell
- CSF/Cochlear implant
If I need the PCV 13 but just received PPSV 23 when should I give it?
Wait at least 1 year
If I haven’t received any pneumoccocal vaccines and need both, how should I give it?
PCV 13 followed by PCV 23 at least 8 weeks later
How many doses of Gardasil 9 are needed?
two ONLY IF initiated before age 15 and doses were AT LEAST 5 months apart
What is the sequence of smoking cessation medications you should try?
Nicotine replacement –> buproprion (sustained release) –> Chantix
Can always add nicotine replacement on top of other meds
How many cigarettes per day warrant medications for the aid of cessation
10-15 cigarettes per day
SOR A
Which TCA has been shown to be effective in smoking cessation?
Nortriptyline - careful about anticholinergic side effects
off label use
How often should pregnant patients receive Tdap vaccine
every pregnancy between 27-36 weeks
What chronic condition was recently added to indications for Hep B vaccine?
- Chronic liver disease including Hep C infection, LFTs twice normal level
Definition of secondary prevention
Activities aimed at early disease detection, increasing opportunities for intervention
SCREENING
How do you decide who needs BRCA testing?
- Ask about family hx of breast, ovarian, tubal or peritoneal cancer
- Use a risk assessment tool
What is the USPSTF recommendation on breast cancer screening?
Grade B - biennial screening for women age 50-74
Grade C - women age 40-49 for women who place greater weight on potential benefit than potential harms
Grade I - everyone else
USPSTF recommendation on prescription of medications to decrease breast cancer risk
Grade B - Offer to prescribe meds if increased risk of cancer but low risk for adverse side effects - tamloxifen, raloxifene, aromatase inhibitors
Grade D - don’t prescribe for women who are not at increased risk
Definition of Tertiary prevention
reduces negative impact of an already established disease by restoring function and reducing disease related complications
Example: Heart Failure
Definition of Quaternary prevention
Activities to mitigate or avoid consequences of unnecessary or excessive intervention of the health system
“ do no harm”
