Health/screening Flashcards
A rare type of cancer involving the skin of the nipple and, usually, the areola. May also have one or more tumors inside the same breast, either ductal carcinoma in situ or invasive breast cancer.
Paget’s disease
that paget guy has breasts… i can see his nipples through his shirt
Also known as measles,
Rubeola
Koplik’s spots (tiny white spots in buccal mucosa) are present during the prodromal period. The blotchy pink rash is also known as a morbilliform rash
Rubeola S/S
Outbreaks caused by poor MMR immunization numbers
Measles
an acute or chronic inflammation of the labial mucosa and adjacent skin due to excessive moisture and/or salivation. The corners of the mouth are macerated with fissures and painful reddened skin
Cheilosis
angular cheilosis (perleche)
“cheeeeel essay- i got the dentures right here”
Are dentures, poor oral hygiene, drooling, dry mouth (sicca symptoms), oral fungal infection, immunodeficiency, and vitamin deficiency.
Cheilosis Risks
(inflammatory condition that causes cracking, crusting, and scaling of the corners of the mouth.)
enough with the lip chap essa…. CHEeeeeeeeeIL
Technique used with a light source, such as the otoscope, to visualize fluid below the skin surface, which will appear as a “glow.”
Transillumination
Stroking the inner thigh (proximal to distal) with a blunt instrument such as a handle of the reflex hammer.
testicle and scrotum should rise on the stroked (ipsilateral) side.
Cremasteric reflex
U.S. Mortality Statistics
Leading cause of death (all ages/genders):
Heart disease (females 22%, males 24%)
Cancer (females 21%, males 22%)
Accidents/unintentional injuries
Cancer Mortality
Top three cancer deaths (all ages/genders):
- Lung and bronchus
- Colon and rectum
- Pancreas
Cancer is more common in older adults; 80% of all cancers in the United States are diagnosed in people aged 55 years or older.
Leading Causes of Death in Adolescents
**Death rate for teen males is higher than for females:
Unintentional injuries (40.6%); the most common cause is motor vehicle crashes (risk is highest from 16 to 19 years of age).
**Suicide (19.0%); watch for signs of depression, such as talking about suicide, saying goodbye to friends and family, social isolation, social media updates about death. Interview teen with parent, then alone (without parent). Refer to pediatric psychiatrist/therapist for further evaluation.
**Homicide (14.3%); nonfatal and fatal violence are much higher among young people compared with any other age group.
Leading Cause of Mortality by Age Group
Birth to 12 months: Congenital malformations
Aged 1 to 44 years: Unintentional injuries
Aged 45 to 64 years: Cancer
Aged 65 and older: Heart disease
Life Expectancy
Average life expectancy in the United States was 78.7 years in 2018 (CDC, 2020). Life expectancy for females is 81.2 years, and life expectancy for males is 76.2 years.
Most common cancer:
Most common type of ____cancer:
Skin cancer (5.4 million)
Basal cell carcinoma
Melanoma causes the majority of skin cancer deaths.
Most common cancer by gender (prevalence):
Most common cancer among children (aged 0–14 years):
Men: Prostate cancer
Women: Breast cancer
Leukemias (approximately three out of four have acute lymphocytic leukemia).
Sensitivity
A sensitive test is very good at identifying/detecting those people who have the disease (true positive).
An easy way to remember is to think of “sensitivity—rule in” or “SIN.”
Specificity
A specific screening test is very good at identifying/detecting those people without the disease (true negative).
An easy way to remember is to think of “specificity—rule out” or “SPOUT.”
Primary Prevention (Prevention of Disease or Injury/Eliminate or Reduce Risk Factors for an Illness)
“Primary= Protect/Promote”
**Individual actions (healthy individuals): Eat a nutritious diet, exercise, and use seatbelts and helmets.
**Gun safety: Use safety locks for guns; keep guns out of reach of children/teens.
**National programs: Federal health-promotion/disease-prevention programs include immunizations, the Occupational
**Safety and Health Administration’s (OSHA) job safety laws, and Environmental
**Protection Agency (EPA) laws.
**Promote a healthy lifestyle and change risky behaviors (e.g., poor eating habits, tobacco use, not using condoms).
**Build a youth center in an urban high-crime area or a Habitat for Humanity house.
**Use aspirin prophylaxis for primary prevention of cardiovascular disease (CVD) and colorectal cancer in adults aged 50 to 59 years who have a 10% risk or higher (who are not at increased risk of bleeding).
Secondary Prevention (Early Detection of a Disease to Minimize Bodily Damage)
“Secondary= screening”
**Screening tests (e.g., Pap smears, mammograms, complete blood count for anemia)
**Screening for depression (interviewing a patient about feelings of sadness, hopelessness)
**Screening for sexually transmitted infections (STIs), such as testing for chlamydia and gonorrhea and asking about sexual history and partners and signs/symptoms
**Screening for alcohol abuse (interviewing a patient using the CAGE questionnaire)
**Testing for hepatitis C virus (anti-HCV) in persons with risk factors, such as an adult born from 1945 to 1965 (baby boomers), long-term hemodialysis, received blood/blood component transfusion (before July 1992), injection drug users, HIV infection, and persistently abnormal alanine aminotransferase (ALT) levels
**Having a person with a history of myocardial infarction (MI), transient ischemic attack (TIA), or stroke take an aspirin or statin daily (to prevent a future stroke or MI)
Tertiary Prevention (Reduce Impact of Disease or Injury/Rehabilitation/Support Groups/Equipment)
“Tertiary=treat current issue”
**Support groups: Alcoholics Anonymous (AA), breast cancer support groups, HIV support groups
**Education for patients with preexisting disease (e.g., diabetes, hypertension):
**Avoidance of drug interactions, proper use of wheelchair or medical equipment, and so on.
**Rehabilitation: Cardiac rehabilitation, physical therapy (PT), occupational therapy (OT)
**Vocational rehabilitation programs to retrain workers for new jobs (after they have recovered as much as possible)
USPSTF Recommendations: Aspirin Use to Prevent Cardiovascular Disease and Colorectal Cancer (April 2016)
**Aged 50 to 59 years with ≥10% CVD risk: Initiate low-dose aspirin use for primary prevention of cardiovascular and colorectal cancer in patients who are not at increased risk for bleeding with life expectancy of at least 10 years and who are willing to take low-dose aspirin daily for at least 10 years
**Aged ≥70 years: Insufficient evidence about aspirin use for primary prevention
USPSTF Recommendations: Breast Cancer (January 2016)
mammo at age:
and every:
until:
high risk should start at:
**Baseline mammogram: Start at age 50 years and repeat every 2 years until age 74 years
Aged ≥75 years: Insufficient evidence for routine mammogram
**Does not apply to women with known genetic mutations (BRCA1 or BRCA2), familial breast cancer, or a history of chest radiation at a young age or women previously diagnosed with high-risk breast lesion who may benefit from starting screening in their 40s
**Evidence is insufficient to assess the balance of benefits and harms of adjunctive screening for breast cancer using breast ultrasonography, MRI, digital breast tomosynthesis (DBT), or other methods in women identified to have dense breasts on an otherwise-negative screening mammogram.
Cervical Cancer Screening
Aged 20 years or younger:
Aged 21–29 years:
Aged 30–65 years:
Prior hysterectomy with removal of cervix:
Aged >65 years with adequate prior screening:
Aged 20 years or younger:
-Do not screen (even if sexually active with multiple partners); cervical cancer is rare before age 21 years
Aged 21–29 years:
-Every 3 years with cervical cytology alone
Aged 30–65 years:
-Every 3 years with cervical cytology alone
-every 5 years with high-risk human papillomavirus (hrHPV) testing alone, or every 5 years with hrHPV testing in combination with cytology
Prior hysterectomy with removal of cervix:
-If hysterectomy with cervical removal was not due to cervical intraepithelial neoplasia (CIN grade 2) or cervical cancer, stop screening
Aged >65 years with adequate prior screening:
-Do not screen if history of adequate prior screening and is otherwise not at high risk for cervical cancer
“no need/ every 3/ 3-5”
USPSTF Recommendations: Colorectal Cancer (June 2016)
start at age:
and every:
until:
different kind of screenings
Baseline: Starting at age 50 years until the age of 75 (older age is the most common risk factor)
Aged 76 to 85 years: Against routine screening but “there may be considerations;” individualize screening as needed.
Aged ≥85 years: Do not screen.
There are several methods that are acceptable for screening people with average risk of colon cancer:
-Colonoscopy every 10 years
-Flexible sigmoidoscopy or CT colonography every 5 years
-**High-sensitivity fecal occult blood test (FOBT) or fecal immunochemical test (FIT) every year (if positive, needs colonoscopy)
-Stool DNA (SDNA) every 1 or 3 years (if positive, needs colonoscopy)
“Q 10 colonoscoPY, Q 5 sigmoid or CT, fecal blood test annuALLY”
