Lecture 6: Approach to Health Maintenance and Counseling

Question 1

What should be included in the history of a well visit?

Answer 1

• What we already do (thorough)
• All of FEDTACOS
• Risk factors based on lifestyle history and family history

Question 2

What is the USPSTF recommendation?

Answer 2

Recommendations with a letter grade

-goal is optimize preventive services

Question 3

Which USPSTF grades should almost always be followed?

Answer 3

A and B

Question 4

What is evidence based medicine?

Answer 4

How provide patients most effective care based on available and best evidence
-comes from published data of outcomes

Question 5

What are some examples of preventive services?

Answer 5

• Screenings
• Immunizations
• General health guidance
• Counseling to reduce risk

Question 6

What is primary prevention?

What are some examples?

Answer 6

Intervention to prevent disease

• vaccinations
• diet, tobacco counseling

Question 7

What is secondary prevention?

What are some examples?

Answer 7

Screening tests for a disease early

• Blood pressure checks
• Labs
• Mammograms

Question 8

What is tertiary prevention?

What are some examples?

Answer 8

Clinical intervention to prevent progression of disease

• Medication
• Chemotherapy

Question 9

What are some factors that prioritize what preventive services should be recommended to patient?

Answer 9

Age
Gender
Family History
Personal risk factors

Question 10

How often should a healthy individual under the age of 50 visit for a wellness checkup?

Answer 10

Every 3 years

Question 11

How often should a healthy individual over the age of 50 visit for a wellness checkup?

Answer 11

Every year

Question 12

At what age range should colonoscopies be done at?

Answer 12

Ages 50-75

*both males and females

Question 13

At what age range should lung cancer screens be done at?

Answer 13

Ages 55-74 years if there is at least a 30 pack year history of smoking

Question 14

At what age range should cervical cancer creening be done at?

Answer 14

Pap smear between ages 21-65

Question 15

At what age range should breast cancer creening be done at?

Answer 15

Normally 50-65 but can be as early as 40

Question 16

What factors are screened for to establish cardiovascular risk?

Answer 16

Diet
Smoking
Physical Activity
Hypertension
Dyslipidemia
Diabetes
Obesity

Question 17

How often should a Tdap vaccine be administered?

Answer 17

Once every 10 years

Question 18

Until what age can HPV vaccine be administered?

Answer 18

Age 26

Question 19

Wgaht age group should receive Zoster vaccine?

Answer 19

50 years and older

Question 20

Who should receive Pneumococcal vaccine?

Answer 20

65 years and older

Question 21

Who should receive Hep B vaccine?

Answer 21

• 65 years and older

- Those with increased risks

Question 22

What are important things to keep in mind when counseling a patient?

Answer 22

• Open ended questions
• Affirmations of positive feelings
• Reflections that reiterate what patient stated
• Summary of conversation

Question 23

What are some therapies for tobacco use?

Answer 23

• Sustained release bupropion
• Nicotine gum, inhaler, lozenge, nasal spray
• Nicotine patch
• Varenicline (Chantix)