Health Screening in the General population Flashcards
What is primordial prevention?
Prevent penetration of risk factors in a population
What is primary prevention?
Limit the incidence of disease by controlling the causes/risk factors
What is secondary prevention?
Interrupting the disease before it becomes symptomatic
What is tertiary prevention?
Limit the physical and social consequences of symptomatic disease
What is health screening?
identifying apparently healthy individuals who may be at increased risk of a disease or condition; looks for diseases before symptoms appear
What are the criteria for an appropriate screening test (3)?
- Common
- Morbidity/mortality risk high
- Must be able to treat (better than reactionary)
What is a surrogate marker?
Lab measurement or physical sign that is used in therapeutic trials as a substitute for a clinically meaningful endpoint
What are guidelines?
Safest route of addressing an issue
What is prevalence?
Proportion of people in a population who have a given disease or atribute
What is sensitivity?
It is measured as the proportion of those with the condition, who have a positive test result. It is the same as the detection rate.
What is specificity?
It is measured as the proportion without the condition, who have a negative test result
What is positive predictive value?
the probability that a patient with a positive (abnormal) test result actually has the disease.
What is negative predictive value?
probability that a person with a negative (normal) test result is truly free of disease.
What is the equation for positive predictive value?
True positives/total positives
What is the equation for negative predictive value?
True negatives / total negatives
What does it mean for a credible guideline to be broad-based?
Should go beyond effectiveness to look at harm, cost, and other clinically relevant factors
What does it mean for a credible guideline to have receny?
Not out of date
What does it mean for a credible guideline to have imprimatur?
Guidelines are respoected by professional organizations
What grade of the USPSTF is recommended against doing something?
C or lower
What are the guidelines for
140/90
What are the guidelines for >60 for HTN?
150/90
What are the guidelines for DM/CKD pts with HTN?
140/90
What is the recommendation for screening children for HTN?
No clear benefit
What is the recommendation for screening elderly for HTN?
Consider checking standing readings after one and three minutes to screen for postural hypotension, especially in the elderly.
What is the recommendation for screening blacks for HTN?
Same BP, but put on thiazide/Ca channel blockers
What percent should you treat with statins, after using the calculator?
7.5%
What is part of the risk determination for CVD: HDL, LDL, or total cholesterol?
HDL and total,
What is the gold standard for colon cancer screening?
Colonoscopy q 10 years
How often do you get a flexible sigmoidoscopy with FOBT?
5 years
When should you stop screening for CVD?
No set time of stopping
What is the age range for colonoscopy?
50-75
What is the grade for colon cancer screening for ages 75+? 85+?
C
D
When should children have their first eye exam?
3-5 years
Blacks have a higher risk for what eye disease?
glaucoma
What are the advantages of hearing screening?
none
What is the grade for assessing coronary Ca levels?
I
True or false: there is no benefit from eye screening for the elderly
True
What are the guidelines for aortic aneurysm screening?
after age 65, male, 100+ packs of cigarettes
True or false: ankle-brachial index is a good screening procedure for PVD
False
What are the guidelines for screening for lung CA (age, risk factors)?
55-80 yo, 30 pack year, currently smoking, or quit within past 15 years
PSA screening in men under what age is not recommended?
40 or low risk until 54
PSA screening at what age should be weighed against potential dangers?
55-69
What age range is testicular CA most common?
15-34
What is the screening guidelines for testicular cancer?
none
The USPSTF recommends against screening for testicular cancer in adolescent or adult males. What grade?
D
What is the grade for mammography?
B
What are the age range for biennial mammography?
50-74 yo
What is the USPSTF guidelines for starting mammography prior to 50 yo?
C
What is the grade for teaching self breast exam?
D
What is the grade for clinical breast exam prior to 40?
I
What is the grade for using MRIs instead of mammograms?
I
What is the age range for cholesterol screening?
assess every 4-6 years ages 20-79
What are good HDL values? What about if they have CVD?
> 35 mg/dl
> 45 mg/dl
What is the level of LDL that indicates when patient should start statins?
> 190 mg/dl
What is the level of LDL that indicates when patient with DM should start statins?
70-189 mg/dl
What is the benefit of coronary artery Ca scoring?
Grade I
When should annual CT screening of lungs be stopped in smokers?
after 15 years of not smoking, or if some other disease limits benefit
When is PSA testing absolutley contraindicated?
70 or with less than 10-15 life expectancy
What are the three major STIs that pregnant women should receive?
Hep B
HIV
Syphilus
How often are pap smears done? What age do they start at?
q 3 years, after sexual activity
When should BP checks start How often?
18 years of age, q2 years