Oncology/preventive medicine Flashcards
tamoxifen toxicitiy
endometrial cancer
clots
aromatase inhibitos tox
osteoporosis
traztuzumab
decreases risk and recurrent disease
adjuvant chemotherapy indication
1-.lesions larger than 1 cm
2-.positice axillary lymph nodes are found
lower mortality in breast cancer
- mammography
- ER/PR testing,then tamoxifen/raloxifen
- aromatase inhibitor
- adjunvant chemoterapy
- lympectomy and radiation
- modified radical mastectomy
- trastuzumab
- prophylaxis with tamoxifen
lung cancer screening
low dose chest CT in a patient with 30 pack-years smoking history YEARLY from 55-80
HPV vaccine indication
every womenbetween ages 11-26
pap smear infiaction
after 21 every 3 years, or every 5 if HPV DNA testing its made. STOP at 65
ASCUSn + … next step
do a HPV DNA test,
-if positive colposcopy.
brest cancer screening indication
startin al 4o every 2 year, stop at 75
colonoscopy screening
every 10 years after 50 years
shingles vaccine indication
everyone over 60
Td indication
every 10 years
osteoporsosis screening indication
women>65 DEXA
AAA indication
all men ever smoking at 65
lipid screening indication
men over 35
women over 45
screening for diabetes
any patient with hypertension or hyperlipidemia
GENERAL POPULATION IS NO CLEAR
patient over 50
use inactivated (DEAD) flu vaccine
hepatitis B vaccine indication
- end stage renla disease( dialysis)
- healthcare workers
- diabetes
hepatitis A vaccine indication
travelers to coundtries of high endemicity
DEXA scan indication
at the age of 65
most common finding lipid profile in methabolic syndrome
increase TGC and low HDL
Live vaccines
- MMR
- zoster
- varicella
- live influenza
Malarie prophylaxis for chloroquine-sensitive areas(CENTRAL AMERICA)
- caribean
- mexico
- costarica
- argetina
- el salvador
- paraguay
- chloroquine
- atovaquone/proguanil(co traindicated in Renal clearance below 30)
- doxycycline
malarie prophylaxis for chloroquine-resistent areas
- mefloquine
- doxycycline
screening for all sexually active women under 25
- PCR for N.gonorrhea and chlamydia
- HIV
what to do with a colon polyps?
rmeove any polyp larger than 1cm
most sensitive modality for ovarian cancer
CA125 conviened with a transvaginal ultrasound
raloxifeno
prevention and treament of osteporosis
asthma patients vaccination
-inactivated influenza and pneumocco vaccine
patients who should recive the inactivated form of influenza insted of the activated
- inmunocompromised
- cardiovascular, pulmanary,metabollic disease
- guillina barre
- pregnant
barret esophagous followin after endoscopy finding:
- WITHOUT dysplasia:
- LOW dysplasia:
- HIGH dysplasia:
- WITHOUT dysplasia: endoscopy every 3 years
- LOW dysplasia: every 6 to 12 m
- HIGH dysplasia:every 3 month
smoking sesation aid
nicotine patch and gums as needed
if you dont know the inmunization status what to choose:
Td or TdaP?
if you dont know give TdaP and inmunoglobulin
tetanus vaccination
- CONTAMINATED with dirt,feces,soil or salive(like a bite), requires a tetanus vaccination if the last one was more than 5 years.
- clean wound 10 years
when to screen HNPCC(2 generations, 1 premature)
-Colonoscopy at 25 years(YEARLY)
FAP when to screen?
-SIGMOIDOSCOPY at 12 y
when to screen with previous adenomatous poly
-COLONOSCOPY every 3-5 Y
previos colon cancer history when to screen
-COLONOSCOPY 1 year,then at 3years, and every 5 years.
Heb B indication
3 dosis
- Birth
- 2m
- 6m
Rotavirus(2 dosis)
- 2m
- 4m
DTaP(5 doses)
- 2m
- 4m
- 6m
- 15m
- 6y
Hib(4 doses)
- 2m
- 4m
- 1y
- 15m
PVC13(4 doses)
-2m
-4m
-6m
1y
polio (SALK) 4 doses
- 2m
- 4m
- 6m
- 6y
MMR(2 doses)
- 1y
- 6y
VAR
- 1y
- 6y
hepA
-1y
meningococcal
-11y
vaccine at birth
HepB
vaccines at 2 months(6 vaccines)
- HepB
- rotavirus
- DTaP
- Hib
- PVC13
- polio (SALK)
vaccines at 4 months(5 doses)
- RV
- DTaP
- Hib
- PVC13
- SALK
vaccines at 6 months(3 dosis)
- HepB
- DTaP
- PVC13
- SALK
live vaccines
- MMR
- sabin(polio)
- yellow fever
- influenza(nasal)
killed vaccines
- cholera
- HAV
- SALK
- rabies
- influenza(IM)
what happens if you lower the cut off point
-INCREASE IN SENSITIVITY
increase in True positive
what happens if you increase the cut off point
-INCREASE IN SPECIFICITY
type 1 errer(alphs)
false postive(null hypothesis is incorrectly rejected)
type II error(betha)
false negative (null hypothesis is not rejected when it is in fact false)
Relative rist over 1
disease is more likely to occur in the exposed group
reative risk under 1
disease is less likely to occur in the exposed group (PROTECTIVE)
