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Patient Care II > Health Promotion and Disease Prevention > Flashcards

Health Promotion and Disease Prevention Flashcards

1
Q

What are the four main preventative care services?

A

Immunizations
Screening
Behavioral Counseling
Chemoprevention

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2
Q

What are the three categories of prevention?

A

Primary, Secondary, and Tertiary prevention

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3
Q

In Primary Prevention do patients already have established disease?

A

No, patients do not have the disease yet. The goal is to prevent the disease from occurring (example: immunizations)

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4
Q

What is the goal of secondary prevention?

A

Patient already have the disease (usually early stage) or at high risk for disease and the goal is for early detection and cure, prevent disease progression

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5
Q

What are some examples of secondary prevention strategies?

A

HIV screening, insulin resistance

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6
Q

What is tertiary prevention?

A

Patient already has the disease and the goal is to prevent progression/deterioration (essentially treatment)

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7
Q

Can certain prevention screenings or interventions fall into several prevention strategy categories?

A

Yes, for example colonoscopy

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8
Q

What are the three things to considering what we should screen for?

A
  1. How great is the burden of the disease?
  2. How good is the screening test?
  3. How good is the treatment?
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9
Q

What are the D’s in burden of disease?

A

Death
Disease
Disability
Discomfort
Dissatisfaction

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10
Q

What is sensitivity?

A

Probability that a patient with the disease will have a positive test (true positive)

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11
Q

What is sensitivity actually telling you when the test comes back negative?

A

High sensitivity rules out if the result is negative (SNOUT)

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12
Q

What is specificity?

A

The probability that a patient without the disease will test negative

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13
Q

What is specificity actually telling you when the test comes back positive?

A

High specificity rules in if the result if positive (SPIN) - they probably have the disease

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14
Q

What is positive predictive value?

A

Likelihood that a person with a positive test has the disease, dependent on prevalence

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15
Q

What is negative predictive value?

A

Likelihood that a person with a negative test does not have the disease, dependent on prevalence

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16
Q

Is it easier to tell someone they don’t have disease (negative predictive value) or that they do (positive predictive value)?

A

That they don’t have a disease

17
Q

What is the goal for screening tests?

A

Simplicity for the patient and cost

18
Q

What is the number one harm of preventative care?

A

Dealing with false positive tests

19
Q

What is lead time bias?

A

People who are diagnosed with screening survive longer after diagnosis that patients who present symptomatic, even if early treatment doesn’t make a difference

20
Q

What is a way to avoid lead time bias?

A

Use mortality rates rather than survival rates

21
Q

What is length time bias?

A

Comparing a short growing cancer to a fast growing

22
Q

What is compliance bias?

A

Compliant patients have a better prognosis than non-compliant patients, regardless of screening

23
Q

What is the difference between internal and external validity?

A

Internal validity are the results of the patients studied vs. external validity is how generalizable the results are to the patients not studied

24
Q

What is the U.S. Preventative Services Task Force (USPSTF)?

A

An independent, volunteer panel of national experts in disease prevention and evidence-based medicine that make evidence-based recommendations about clinical preventitive services- goal is primary prevention

25
Q

What does the USPSTF not make recommendations on?

A

Immunizations, that falls under the CDC advisory committee

26
Q

Who should get the Pneumovax (PPSV-23) vaccine?

A

> /= 65 years old and with shared decision making to determine if they should get Prevnar (PCV-13)

27
Q

What is a live, attenuated vaccine?

A

Have a live version of the organism that has been weakened (attenuated) so that it doesn’t cause disease in patients with healthy immune systems.

Can’t give to patients who are immunocompromised.

28
Q

How many doses are typically needed for live, attenuated vaccines for life-long immunity?

A

1-2 doses for life-long immunity because your immune system is seeing the actual virus

29
Q

What are inactivated vaccines?

A

Use a killed version of the germ, may need several boosters to get long-term immunity or maintain immunity

30
Q

What are some examples of inactivated vaccines?

A

Polio injection, hepatitis A

31
Q

What are subunit vaccines?

A

Contain part of the germ (often essential antigen), do not cause infection, less side effects

32
Q

What is an example of a subunit vaccine?

A

Pertussis

33
Q

What is a toxoid vaccine?

A

Prevent disease that are due to toxins that are produced by bacteria, use a weakened form of the toxin (toxoid)

34
Q

What is a conjugate vaccine?

A

Prevents an immature immune system from recognizing the polysaccharides produced by some bacteria - immune system reacts to the polysaccharides

35
Q

What is an example of a conjugate vaccine?

A

Hib

36
Q

What are the major contraindications to giving vaccines?

A

Anaphylaxis to vaccine or component
Pregnancy
Severe immunodeficiency
Encephalopathy within 7 days of getting DTP

37
Q

What are some precautions to vaccines?

A

Patient is moderately to severely ill
Received immunoglobulin
Use caution if severe-side effects in the past (Guillain-Barre, seizures, high fevers)

38
Q

What are some examples of chemoprevention?

A

Use of statins
Tobacco cessation
Aspirin to prevent ASCVD and colorectal cancer

Patient Care II (11 decks)

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