Office- Screenings/Vaccinations Flashcards
What is the recommendation for colon cancer screening?
If average risk= starts at age 45-85 q 10 years
If positive family history starts 10 years prior to relative being diagnosed
If 1 first degree relative affected repeat 5 years
If 2 or more first degree relatives affected repeat in 3 years
What is the screening recommendation for colon cancer if colonoscopy was positive?
If a benign polyp repeat in 3-5 years
If polyp with atypia repeat in 3 years
What are the screening options for colon cancer?
Colonoscopy
Sigmoidoscopy
FOBT
FIT
CT colonography
What is the breast cancer screening recommendations?
40-75 years old
Annually 40-54
Biennal 55-75
What is the recommended screening for lung cancer?
Annual low dose chest CT for adults age 50-80 with smoking history and current smoker or quit <15 years ago
What is the recommended next step for evaluation of abnormal breast imaging result?
Core needle biopsy
What is the management of breast cysts on imaging?
BIRADS 2= observation, can aspirate if symptomatic
Non simple cyst= observation, aspiration or biopsy
When is it recommended to test for BRCA mutation?
Greater than 20% chance breast cancer based on family history
What is the inheritance pattern for BRCA mutations?
Autosomal dominant
What is the screening recommendations for breast cancer in a patient with positive BRCA 1 or 2?
Clinical breast exam q 6 months
Annual MRI at age 25-29
Annual MRI and mammogram at age 30
What is the screening recommendations for ovarian cancer in a patient with positive BRCA 1 or 2?
No screening recommended
Can consider Ca125, pelvic ultrasound yearly at age 30-35
What is the breast cancer risk for BRCA 1?
65-74%
What is the ovarian cancer risk for BRCA 1?
40%
What is the breast cancer risk for BRCA 2?
65-74%
What is the ovarian cancer risk for BRCA 2?
20%
What cancer risks are increased with BRCA mutations?
Breast
Ovarian
Gastric
Melanoma
Pancreatic
Prostate
What is the chemoprevention option for breast cancer?
Tamoxifen
What is the chemoprevention option for ovarian cancer?
OCPs
When is risk reducing surgery for BRCA mutation recommended?
Salpingoopherectomy by age 40 or when child bearing complete
prophylactic mastectomy
BRCA1=35-40
BRCA2=40-45
What is recommendation for tetanus vaccination?
1 time dose of TDAP then Td every 10 years
TDAP in each pregnancy between 27-36 weeks
What is the recommendation for MMR vaccination?
Single dose recommended unless high risk then should receive 2 doses
What people are high risk for MMR and should receive vaccination?
healthcare workers
College students
International travelers
Rubella negative postpartum patients
Who is recommended for hepatitis A vaccination?
Childhood vaccination 2 doses 6 months apart
International travelers
Ilicit drug users
Who is recommended for hepatitis B vaccination?
Pts age 13-18
healthcare workers
Dealing with or receiving blood products
IV drug users
More than 1 sexual partner
Recent or current STD
Hepatitis B household contacts
Who is recommended for influenza vaccine?
everyone annually after age 6 months
Who should receive pneumococcal vaccination?
Age 65
Immunocompromised
splenectomy
Chronic medical illness
Who should receive meningococcal vaccine?
Everyone by age 15 or prior to high school/military service
Who should receive varicella vaccine?
All adults without proven immunity
DO NOT GIVE IN PREGNANCY!!
Who should receive zoster vaccine?
All adults age 50 and older
2 doses
Who should receive HPV vaccine?
Age 9-45 years old
9-14 years old= 2 doses (0,6 months)
15-45 years old= 3 doses (0,2,6 months)
Can you give HPV vaccine in pregnancy?
No
Can you give HPV vaccine in lactating mothers?
Yes
What does the HPV vaccine consist of?
9 valent vaccine
(6,11,16,18,31,33,45,52,58)
Can the patient have HPV vaccine if they have a history of abnormal Pap smear?
Yes
What does the HPV vaccine reduce risk of?
Anogenital cancer
Oropharyngeal cancer
Genital warts
Who should receive COVID vaccine?
Everyone age 12 and older
Can you use statin therapy in pregnancy?
No
What is the leading cause of death in women?
CVD
What are risk factors for CVD?
Age
Family history of premature CHD
HTN
Diabetes
Current cigarette smoking
Obesity
Sedentary lifestyle
Low HDL
When should statins be prescribed?
Clinical CVD
LDL >190
History of DM with LDL 70-189
LDL 70-189 and 10 year risk of CVD >7.5%
How much does a moderate intensity statin decrease LDL?
30-50%
How much does a high intensity statin decrease LDL?
> 50%
Recommendation for zoster vaccination?
Aduts age 50 and older
High risk factors for pneumococcal disease?
Alcohol use disorder
Chronic liver, lung, heart disease
Smoker
Diabetes
Hemoglobinopathies
Immunocompromised
