Health Promotion and Disease Prevention - FITZ Flashcards
- An example of a primary prevention measure for a
78-year-old man with chronic obstructive pulmonary
disease is:
A. reviewing the use of prescribed medications.
B. conducting a home survey to minimize fall risk.
C. checking FEV1 (force expired volume at 1 second)
to FVC (forced vital capacity) ratio.
D. ordering fecal occult blood test (FOBT).
B. conducting a home survey to minimize fall risk.
- Which of the following is an example of a primary
prevention activity in a 76-year-old woman with
osteoporosis?
A. bisphosphonate therapy
B. calcium supplementation
C. ensuring adequate illumination in the home
D. use of a back brace
C. ensuring adequate illumination in the home
- Secondary prevention measures for a 78-year-old man with chronic obstructive pulmonary disease include:
A. screening for mood disorders.
B. administering influenza vaccine.
C. obtaining a serum theophylline level.
D. advising about appropriate use of car passenger
restraints.
A. screening for mood disorders.
- Tertiary prevention measures for a 69-year-old woman with heart failure include:
A. administering pneumococcal vaccine.
B. adjusting therapy to minimize dyspnea.
C. surveying skin for precancerous lesions.
D. reviewing safe handling of food.
B. adjusting therapy to minimize dyspnea.
- Which of the following products provides passive
immunity?
A. hepatitis B immune globulin (HBIG)
B. measles, mumps, and rubella (MMR) vaccine
C. pneumococcal conjugate vaccine
D. live attenuated influenza vaccine (LAIV)
A. hepatitis B immune globulin (HBIG)
- Active immunity is defined as:
A. resistance developed in response to an antigen.
B. immunity conferred by an antibody produced in
another host.
C. the resistance of a group to an infectious agent.
D. defense against disease acquired naturally by the
infant from the mother.
A. resistance developed in response to an antigen.
7. Which of the following is usually viewed as the most cost-effective form of healthcare? A. primary prevention B. secondary prevention C. tertiary prevention D. cancer-reduction measures
A. primary prevention
- An 18-year-old woman with allergic rhinitis presents for primary care. She is sexually active with a male partner and is 1 year post-coitarche; during that time she had two sex partners. An example of a primary prevention activity for this patient is:
A. screening for sexually transmitted infection.
B. counseling about safer sexual practices.
C. prescribing therapies for minimizing allergy.
D. obtaining a liquid-based Papanicolaou (Pap) test.
B. counseling about safer sexual practices.
- When a critical portion of a population is immunized
against a contagious disease, most members of the
group, even the unimmunized, are protected against
that disease because there is little opportunity for an
outbreak. This is known as _________ immunity.
A. passive
B. humoral
C. epidemiologic
D. community
D. community
Primary prevention measures
include activities provided to individuals
to prevent the onset or acquisition of a given disease
The goal of primary prevention measures
is to spare individuals the suffering, burden, and cost associated with the clinical condition and primary prevention is the first level of healthcare.
Primary prevention example
An example is health-protecting education and counseling, such as encouraging the use of car restraints and bicycle helmets, counseling about safer sexual practices, and providing information on accident and fall prevention.
Given its focus on preventing illness or injury, primary prevention is usually viewed as the most effective form of healthcare.
Immunizations and chemoprophylaxis
examples of primary prevention measures
Secondary prevention measures
include activities provided to identify and treat asymptomatic persons who have risk factors for a given disease or in preclinical disease
Secondary prevention measures example
Examples include screening examinations for preclinical evidence of cancer, such as mammography and cervical examination with a Papanicolaou test.
Other examples of secondary prevention
activities include screening for clinical conditions with a protracted asymptomatic period, such as a blood pressure measurement to detect hypertension and a lipid profile to detect hyperlipidemia
Tertiary prevention measures
are part of the management of an established disease.
Goal of tertiary prevention measures
The goal is to minimize disease associated
complications and the negative health effects of the
conditions to the patient. Examples include medications and lifestyle modification to normalize blood glucose levels in individuals with diabetes mellitus and in conjunction with the treatment of heart failure, aimed at improving or minimizing disease-related symptoms.
Secondary Prevention Principles
Prevalence is sufficient to justify screening
Routine mammography is appropriate in women but not men.
Secondary Prevention Principles
Health problem has significant effect on quality
or quantity of life.
Target diseases for secondary prevention include hypertension, type 2 diabetes mellitus, dyslipidemia, and certain cancers.
Secondary Prevention Principles
The target disease has a long asymptomatic period.
The natural history of the disease, or how the
disease unfolds without intervention, is known.
Treatment is available for the target disease. Providing
treatment alters the disease’s natural history.
Secondary Prevention Principles
A population-acceptable screening test is available
The test should be safe, be available at a reasonable cost, and have reasonable sensitivity and specificity.
Personal Immunization Contraindications
Anaphylactic Reaction History
Neomycin
IPV, MMR, varicella
Personal Immunization Contraindications
Anaphylactic Reaction History
Streptomycin, polymyxin B, neomycin
IPV, vaccinia (smallpox)
Personal Immunization Contraindications
Anaphylactic Reaction History
Baker’s yeast
Hepatitis B
Personal Immunization Contraindications
Anaphylactic Reaction History
Gelatin, neomycin
Varicella zoster
Personal Immunization Contraindications
Anaphylactic Reaction History
Gelatin
MMR
- Which of the following women should have screening for cervical cancer?
A. an 18-year-old who has a history of genital warts
B. a 17-year-old with coitarche 3 years ago and four
male sexual partners
C. an 80-year-old with heart failure and a remote history of normal Pap test results
D. a 21-year-old who has had one male sexual partner
and consistent condom use
D. a 21-year-old who has had one male sexual partner
and consistent condom use
- Which of the following is a recommended
method of annual colorectal cancer screening
for a 62-year-old man?
A. digital rectal examination
B. in-office fecal occult blood test (FOBT)
C. at-home FOBT
D. sigmoidoscopy
C. at-home FOBT
- Which of the following types of cancer screening
is not routinely recommended in a 55-year-old
woman?
A. breast
B. skin
C. endometrial
D. colorectal
C. endometrial
73 to 75. Indicate (yes/no) whether each of the following women should undergo a mammogram to
screen for breast cancer.
- a 37-year-old with a second-degree relative
diagnosed with breast cancer at age 62 years
No
73 to 75. Indicate (yes/no) whether each of the following women should undergo a mammogram to
screen for breast cancer.
- a 53-year-old with no known risk factors for
breast cancer
Yes
73 to 75. Indicate (yes/no) whether each of the following women should undergo a mammogram to
screen for breast cancer.
- a 76-year-old with New York Heart
Association (NYHA) Class III congestive
heart failure
No
- According to the U.S. Preventive Services Task Force, which of the following women would most likely be eligible for genetic testing to detect BRCA mutation in order to assess risk for breast and ovarian cancer?
A. a 42-year-old at average risk of breast cancer
B. a 36-year-old who breastfed three children
C. a 46-year-old with two first-degree relatives with
breast and ovarian cancers
D. a 38-year-old with a first-degree relative diagnosed
with colorectal cancer
C. a 46-year-old with two first-degree relatives with
breast and ovarian cancers
- The components of brief intervention for treating
tobacco use include:
A. Ask, Advise, Assess, Assist, Arrange.
B. Advise, Intervene, Counsel, Follow Up, Prescribe.
C. Document, Counsel, Caution, Describe,
Demonstrate.
D. Advise, Describe, Confer, Prescribe, Document.
A. Ask, Advise, Assess, Assist, Arrange.
- A brief intervention that provides motivation to quit
tobacco use should be:
A. used at every clinical visit that the tobacco user has,
regardless of reason for the visit.
B. offered when the tobacco user voices concern about the health effects of smoking.
C. applied primarily during visits for conditions that
are clearly related to or exacerbated by tobacco use,
such as respiratory tract disease.
D. when the clinician is conducting a comprehensive
health assessment, such as with the annual physical
examination.
A. used at every clinical visit that the tobacco user has,
regardless of reason for the visit.
- The use of FDA-approved pharmacologic intervention in tobacco use:
A. makes little difference in smoking cessation rates.
B. reliably increases long-term smoking abstinence
rates.
C. is helpful but generally poorly tolerated.
D. poses a greater risk to health than continued
tobacco use.
B. reliably increases long-term smoking abstinence
rates.
- You see a 48-year-old patient who started taking
varenicline (Chantix®) 4 weeks ago to aid in smoking
cessation. Which of the following is the most important question to ask during today’s visit?
A. “How many cigarettes a day are you currently
smoking?”
B. “On a scale of 0 to 10, how strong is your desire
to smoke?”
C. “Have you noticed any changes in your mood?”
D. “Are you having any trouble sleeping?”
C. “Have you noticed any changes in your mood?”
nicotine replacement therapy (NRT)
patch, gum, inhaler, nasal spray, and lozenge
medications to reduce the desire to smoke
bupropion [Zyban®, Wellbutrin®]
varenicline [Chantix®]
Ask about tobacco use
Identify and document tobacco use status for every patient at every visit.
Advise to quit
In a clear, strong, and personalized manner, urge every tobacco user to quit.
Assess willingness to make a quit attempt
Is the tobacco user willing to make a quit attempt at this time?
Assist in quit attempt
For the patient willing to make a quit attempt, offer medication and provide or refer for counseling or additional treatment to help the patient quit.
For patients unwilling to quit at the time, provide interventions designed to increase future quit attempts.
Arrange follow-up
For the patient willing to make a quit attempt, arrange for follow-up contacts, beginning within the first week after the quit date.
For patients unwilling to make a quit attempt at the time, address tobacco dependence and willingness to quit at next clinic visit.
