Lecture 1: Wellness Visit Flashcards
What are the top 3 leading causes of death in the US?
- Heart Disease
- Cancer (malignant neoplasms)
- Chronic lower respiratory disease
What is the #1 leading cause of injury mortality in the US?
Unintentional Poisoning
What are the top 3 cancers by rate of new cancer cases?
- Breast (female)
- Prostate
- Lung and Bronchus
What are the top 3 cancers by rate of cancer deaths?
- Lung and Bronchus
- Breast (female)
- Prostate
What does the USPSTF do?
Works to improve the health of all Americans by making evidence-based recommendations about clinical preventive services such as screenings, counseling services, and preventive medications
What does a grade of A, B, C, D, or I from the USPSTF mean?
A = recommends service. High certainty that the net benefit is substantial
B = recommends service. High certainty that the net benefit is moderate or there is moderate certainty that the net benefit is moderate to substantial
C = recommends selectively offering or providing this service to individual pts based on professional judgement and pt preferences. There is at least moderate certainty that the net benefit is small
D = recommends against the service. There is moderate or high certainty that the service has no net benefit or that the harms outweigh benefits
I = current evidence is insufficient to assess the balance of benefits and harms of the service. Evidence is lacking, of poor quality, or conflicting, and the balance of benefits and harms cannot be determined
What does patient-oriented evidence mean?
Measures outcomes that matter to patients: morbidity, mortality, symptom improvement, cost reduction, and quality of life
What is a screening test vs. diagnostic test?
Screening: testing an asymptomatic pt for a specific disease just because they are a certain age, gender, and/or meet other criteria
Diagnostic: testing a symptomatic pt for a specific disease because you, the physician, thinks his symptoms may point to a specific cause
Most physicians refer to what organizations when offering recommended vaccinations?
- CDC (center for disease control)
- ACIP (advisory committee on immunization practices)
What is the recommendation for influenza vaccine?
- All people age 6 months or older should have annual vaccine
- Age 65 or older may opt for the high-dose vaccine
What is the recommendation for Pneumococcal Vaccines (PCV13 and PPSV23)?
- PCV13 for all children younger than 2 y/o, all adults 65 years or older, and people 2-64 y/o with certain medical conditions
- PPSV23 for all adults 65 years or older, people 2-64 with certain medical conditions, and adults 9-64 who smoke cigarettes
What is the recommendation for HPV vaccine for girls, boys, and MSM?
- 3 doses for all girls at age 11-26
- 3 doses for all boys at age 11-21
- 3 doses recommended for MSM or who have other risk factors to age 26
What is the routine Meningococcal Vaccine and the one for special populations; what is the recommendation for administration?
- MenACWY is routine
- MenB for special populations
- Single dose of Menactra or Menevo at age 11 or 12, w/ booster dose at age 16
- Recommended in upper teen years as they approach communal living areas like dorms or military
What is the recommendation for Tdap vaccine; what about during pregnancy?
- Give one dose Tdap, then every 10 years give Td booster
- For people who are around infants, may wish to give a Tdap to protect the adult as well as infants they care for from pertussis (whooping cough)
- Give Tdap once per pregnancy, usually around 27-36 weeks gestation, regardless of last Td or Tdap vaccine timing
Which 3 vaccines are contraindicated in pregnancy, immune-compromsing conditions and HIV w/ CD4 count <200?
- Varicella (chicken pox)
- Varicella Zoster (shingles)
- Measles, Mumps, Rubella (MMR)
