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Family Medicine > OSCE - Screening > Flashcards

OSCE - Screening Flashcards

1
Q

What immunizations should adults be asked about during routine screening visits?

A 
HPV
Flu
Tdap, td
Shingles (60+)
Pneumococcal: 13 or 23 valent
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2
Q

What populations should receive PCV13 and which should receive PCV23?

A

PCV13: 65y+ or risk factors and immunocompromised
PPV23: smokers, asthmatics

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3
Q

Which populations of women should be screened for cervical cancer?

A

Women 21-65 should get Pap smear every 3 years

Women 30-65 can get pap smear with HPV testing every 5 years

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4
Q

Which populations of women should be screened for breast cancer?

A

Women 50-74 should receive mammograms every 2 years

Women

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5
Q

Who gets screened for osteoporosis?

A

Women >65y or under 65 with fracture risks

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6
Q

What is the screening test for osteoporosis?

A

DEXA scan = dual energy xray absorptiometry

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7
Q

Who gets screened for AAA?

A

Men between 65-75y with a smoking history,should get an abdominal ultrasound. Men with risk factors are also screened (HTN, family history, overweight, atherosclerosis, caucasians)

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8
Q

Who gets screened for colon cancer?

A

Men and women between 50 and 75y are screened with FOBT every year, flexible sigmoidoscopy every 5 years, and colonoscopy every 10 years

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9
Q

Describe what a mammogram is

A

Your breasts are compressed between two firm surfaces to spread out the breast tissue. An X-ray captures black and white images of your breast tissue so doctors can look for signs of cancer.

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10
Q

Should patients be taught self-breast exam techniques?

A

No

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11
Q

What are the benefits of routine mammography screening?

A

Reduced mortality, especially between 60-69y

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12
Q

What are the harms of routine mammography screening?

A

Psychological stress
False positives can cause more imaging, biopsies and treatment
Over diagnosis
Radiation exposure

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13
Q

What are the risk factors for breast cancer?

A 
Age
Genetic mutations: BRCA1/BRCA2
No pregnancies
Late age of first pregnancy
No breastfeeding
Obesity
Early menarche/ Late menopause (Estrogen)
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14
Q

What is the treatment for breast cancer?

A

Radiation
Chemotherapy
Surgery

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15
Q

What is considered adequate screening for cervical cancer?

A

3 consecutive negative cytology results or 2 consecutive negative HPV tests in a woman over 65 years old all within the previous 10 years

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16
Q

What are the benefits of routine cervical cancer screening?

A

Decreased cervical cancer incidence and mortality

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17
Q

What are the harms of routine cervical cancer screening?

A

Abnormal results lead to more testing and invasive diagnostic procedures which can cause vaginal bleeding, pain, infection, and inadequate sampling
Increased anxiety/distress
Treatment associated risk
Overdiagnosis (non-clinically significant cancers)

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18
Q

What are the risk factors for cervical cancer?

A

HPV infection
HIV infection (compromised immune system)
Smoking
Many sexual partners, early sexual activity, STI hx
DES exposure in utero
Previous high grade precancerous lesion or cervical cancer

19
Q

What are the treatments for cervical cancer?

A

Ablation, excisional therapy for high grade precancerous lesions
Hysterectomy or radiation for cancer

20
Q

Describe FOBT

A

Test for looking for blood in stool

A spoon/collecting device used to get stool sample which is placed on a card that is sent to doctor or lab

21
Q

Describe sigmoidoscopy

A

A thin flexible tube inserted into the rectum and advanced into colon with a camera at the tip
Looks for polyps/abnormal tissue in the rectum and colon
Requires bowel prep with laxative or enema and may require medication adjustments
Takes about 15 minutes

22
Q

Describe a colonoscopy

A

A long flexible tube inserted into the rectum with a camera at the tip
Looks for polyps/abnormal tissue in rectum and colon
Requires bowel prep with laxative or enema
Requires sedation
You will need someone to drive you home

23
Q

What are the benefits of routine colon cancer screening?

A

Reduced cancer mortality

Less invasive tests reduce number of colonoscopies even though abnormal results require follow up colonoscopy

24
Q

What are the harms associated with colonoscopy?

A

Perforation of the colon (4/10,000)
Serious complications (major bleeding, severe pain) 25/10,000
Poor reaction to sedative

25
Q

What are the harms associated with flexible sigmoidoscopy?

A

Serious complications (major bleeding, severe pain) 3/10,000

26
Q

What are the risk factors for colon cancer?

A 
Family Hx
Inherited syndromes
Inflammatory bowel disease
Obesity
Smoking
Alcohol
Lack of physical activity
African american race
27
Q

What are the guidelines for screening for lung cancer?

A

Individuals 55-80y with a 30 pack year smoking history that are actively smoking or quit within the past 15 years should receive a low dose CT yearly
Stop when quit date is 15y ago
Stop when costs outweigh benefits of screening

28
Q

What harms are associated with routine lung cancer screening?

A 
False negatives
False positives
Incidental findings
Overdiagnosis
Radiation exposure
29
Q

What are the risk factors for lung cancer?

A 
Smoking
Age > 55y
Occupational exposures
Radon exposure
Family history
COPD or pulmonary fibrosis
30
Q

What are the treatments for lung cancer?

A

Surgical removal (early non-small cell lung cancer)
Chemotherapy
Radiation

31
Q

Describe DEXA scans

A

Imaging to detect decreases in bone density
Painless
Low radiation exposure
Takes about 10 to 30 minutes

32
Q

What is the benefit of routine DEXA scan?

A

Prevents osteoporosis related fractures, chronic hip pain, disability, loss of independence and mortality

33
Q

What are the harms of DEXA scans?

A 
False positives
False negatives
Anxiety
Cost
Time
34
Q

What are the risk factors of osteoporosis?

A 
Females
White women
Age
Low BMI
Early menopause
Parental history of hip fracture
Smoking
Alcohol
Corticosteroid use
35
Q

What are the treatments for osteoporosis

A

Medications: bisposphonates, PTH, raloxifene, estrogen, calcitonin
Calcium - 1500mg
Vitamin D - 800 IU

36
Q

What are the guidelines for screening for ovarian cancer?

A

Do not screen

-No mortality benefit by screening with transvaginal ultrasound and CA-125 serum testing

37
Q

What are the risk factors of ovarian cancer?

A

BRCA mutation
Lynch syndrome (HNPCC)
Family history

38
Q

What factors decrease risk of ovarian cancer?

A 
Oral contraceptive use
Pregnancy
Breastfeeding
Bilateral tubal ligation
Removal of ovaries
39
Q

What are the screening guidelines for prostate cancer?

A

Do not screen with PSA

Identifies too many non-clinically significant cancers

40
Q

What are the risk factors for prostate cancer?

A 
Age
Black men
Family history of prostate cancer
Exposure to agent orange
BPH is NOT a risk factor
Prostatitis
Smoking
41
Q

What are the treatments for prostate cancer?

A

Surgery
Radiation
Androgen deprivation therapy

42
Q

What are the screening guidelines for testicular cancer?

A

Do not screen

Very little benefit because most cases are found incidentally

43
Q

What are the risk factors for testicular cancer?

A

Cryptorchidism
History of testicular cancer
Trisomy 21
Klinefelter

44
Q

What are the treatments for testicular cancer?

A

Orchiectomy
Radiation
Chemotherapy
>90% of newly diagnosed cases are cured

Family Medicine (1 decks)

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