Lecture 6: Approach to Health Maintenance and Counseling Flashcards
What should be included in the history of a well visit?
- What we already do (thorough)
- All of FEDTACOS
- Risk factors based on lifestyle history and family history
What is the USPSTF recommendation?
Recommendations with a letter grade
-goal is optimize preventive services
Which USPSTF grades should almost always be followed?
A and B
What is evidence based medicine?
How provide patients most effective care based on available and best evidence
-comes from published data of outcomes
What are some examples of preventive services?
- Screenings
- Immunizations
- General health guidance
- Counseling to reduce risk
What is primary prevention?
What are some examples?
Intervention to prevent disease
- vaccinations
- diet, tobacco counseling
What is secondary prevention?
What are some examples?
Screening tests for a disease early
- Blood pressure checks
- Labs
- Mammograms
What is tertiary prevention?
What are some examples?
Clinical intervention to prevent progression of disease
- Medication
- Chemotherapy
What are some factors that prioritize what preventive services should be recommended to patient?
Age
Gender
Family History
Personal risk factors
How often should a healthy individual under the age of 50 visit for a wellness checkup?
Every 3 years
How often should a healthy individual over the age of 50 visit for a wellness checkup?
Every year
At what age range should colonoscopies be done at?
Ages 50-75
*both males and females
At what age range should lung cancer screens be done at?
Ages 55-74 years if there is at least a 30 pack year history of smoking
At what age range should cervical cancer creening be done at?
Pap smear between ages 21-65
At what age range should breast cancer creening be done at?
Normally 50-65 but can be as early as 40
What factors are screened for to establish cardiovascular risk?
Diet Smoking Physical Activity Hypertension Dyslipidemia Diabetes Obesity
How often should a Tdap vaccine be administered?
Once every 10 years
Until what age can HPV vaccine be administered?
Age 26
Wgaht age group should receive Zoster vaccine?
50 years and older
Who should receive Pneumococcal vaccine?
65 years and older
Who should receive Hep B vaccine?
- 65 years and older
- Those with increased risks
What are important things to keep in mind when counseling a patient?
- Open ended questions
- Affirmations of positive feelings
- Reflections that reiterate what patient stated
- Summary of conversation
What are some therapies for tobacco use?
- Sustained release bupropion
- Nicotine gum, inhaler, lozenge, nasal spray
- Nicotine patch
- Varenicline (Chantix)
