Module 9 Flashcards
What is the current USPSTF recommendation for HIV screening
All pregnant women
At least a baseline for 15-65 year olds and more screening if they are at increased risk
What is a positive ppd reading for a patient with HIV
equal or greater than 5mm
What is the next step for a patient who has a positive rapid HIV test
They need a western blot test to confim a diagnosis. If western blot is negative, HIV is excluded. If the western blot is positive, they have HIV
What are the standard immunizations for a patient with HIV? And how often administered?
Hep A and Hep B (if not immune). Pneumococcal, influenza and tetanus.
Pap every six months to start and then yearly if negative.
What regular primary care is needed for those who are HIV+ (in otherwords, what will you see them for versus an infectious disease doc?)
Paps, cholesterol, vaccines, STD screening, ppd, Prevention of opportunistic infection, etc.
Describe relationship between viral load and CD4 count
The greater the viral load, the faster the CD4 cells get destroyed.
What does an increase or decrease in the viral load mean in relation to disease severity
The greater the CD4 count, the less severe the disease.
At what CD4 count do opportunistic infections become more likely?
When the CD4 count drops below 200.
What is the window of time between infection and seroconversion?
Up to 3 months. If the person is negative and had sex 4 months ago, you can tell them they are negative.
What are three acceptable screening methods for colorectal cancer?
Sigmoid, colonoscopy, and fecal occult
ABCDE system of skin cancer
A=Asymmetry Melanomas are usually asymmetric: a line through the middle will not create matching halves. Benign nevi are usually round and symmetric.
B=Border The borders of melanomas are often uneven and may have scalloped or notched edges. Benign nevi have smoother, more even borders.
C=Color Variation in color. Benign nevi are usually a single shade of brown. Melanomas are often varied shades of brown, tan, or black. As melanomas progress, they may appear red, white, and blue.
D=Diameter Diameter of 6 mm or greater. Melanomas tend to grow larger than most nevi.
E=Evolving Evolving could be in changes in size, shape, symptoms (itching, tenderness), surface (especially bleeding), and shades of color.
What is the best diagnostic procedure to order for suspected malignant melanoma?
A full-thickness excisional skin biopsy is the gold standard for diagnosing melanoma.
What effect does sunscreen have in the prevention of basal cell carcinoma
Regular application of sunscreen has prolonged preventive benefits for squamous cell carcinoma, but has no clear benefit in reducing BCC. Avoid tanning (natural and artificial) and sunburn especially in children
How is high risk defined by the NCCN lung cancer screening guidelines
High-risk, category 1 patients are those 55 to 74 years old with at least a 30 pack-year history of smoking and smoking cessation for less than 15 years.
High-risk, category 2B patients are those at least 50 years old with a 20 or more pack-year history of smoking and 1 additional risk factor (other than secondhand smoke).
What screening is advised for people in the high-risk category
helical low-dose CT screening.
