Preventative Flashcards
Abdominal Aortic Aneurysm Screening
one-time screening with ultrasound for men 65-75 who have ever smoked
Who should get low-dose aspirin prophylaxis and for what?
- recommended for adults 50-59 who have a 10% or greater 10-year cardiovascular risk
- used to lower risk of CRC and cardiovascular disease
When should hypertension screening start?
recommended for anyone over the age of 18
What is the recommendation for BRCA screening?
- screening recommended for women who have family members with breast, ovarian, tubal, or peritoneal cancer using a tool based on family history
- those who test positive should have genetic counseling and BRCA testing
What recommendation is there for the use of medications to prevent breast cancer?
- tamoxifen and raloxifene (SERMs) reduce breast cancer risk compared to placebo
- they have the most benefit for women with 2 or more first-degree relatives with breast cancer, but should be offered based on shared decision making
What are the guidelines for breast cancer screening?
screening mammography for women 50-75 every 1-2 years
What are the recommendations for cervical cancer screening?
- every three years with cervical cytology alone for women 21-29
- every five years with cervical cytology and high risk HPV testing for women 30-65
- it is not indicated for woman who have had a hysterectomy and never had a high-grade lesion
Who should have annual gonorrhea and chlamydia screening?
recommended for sexually active women 24 or younger and in older women who are at increased risk
What is the basic CRC screening recommendation?
- for the general population, do colonoscopy every 10 years from 50-75
- with CRC or adenomatous polyps in any first-degree relative less than 60 or any two first-degree relatives: start at 40 or 10 years younger and go every 5 years
- with CRC or adenomatous polyps in any first-degree relative over 60 or any two second-degree relatives: start at 40 and go every 10 years
When should depression screening start?
age 12
What guidelines are there for diabetes screening?
recommended in those 40-70 years old with a BMI greater than 25, HTN, or HLD using fasting blood glucose or HbA1c
Who should be screened for hepatitis B?
recommended for persons at high risk for infection and in all pregnant women at their first prenatal visit
Who should be screened for hepatitis C?
recommended for all persons at high risk for infection and one-time screening in adults born between 1945-1965
Who should be screened for HIV?
recommended once for all persons 15-65 years old and in those younger or older at increased risk
What are the recommendations for lung cancer screening?
annual screening recommended using low-dose CT for adults 55-80 who have at least a 30 pack year smoking history and have smoked within the past 15 years
Who should receive a routine DEXA scan?
- postmenopausal women younger than 65 at increased risk as determined by a formal assessment tool
- all women at age 65
Which cancer screening provides the greatest mortality benefit?
mammography
For adults, what are the two most beneficial vaccines?
influenza and pneumococcus
For which adult populations should live vaccines not be given?
for adults over age 50 and for adults with chronic medical illness
Who should receive the inactivated flu vaccine?
those 50 years of age or older or who have chronic medical illness
What are the indications for influenza vaccination?
it should be given to everyone yearly
In what sequence should the pneumococcal vaccines be given?
- start with the 13 polyvalent
- after 6-12 months, give the 23 polyvalent
- revaccinate after 5 years for those who are immunocompromised or had their first injection prior to 65
Who is the zoster vaccine indicated for?
all patients above age 50
Hepatitis A and B vaccination are indicated for who?
- both are indicated for all children, adults with chronic liver disease or inject drug use, and men who have sex with men
- HepA is also indicated for travelers
- HepB is also indicated for healthcare workers, diabetics, and those with ESRD
Describe the recommended tetanus vaccination schedule.
- Td should be given every 10 years
- Tdap should be given with every pregnancy and in place of one Td booster
Describe tetanus post-exposure prophylaxis.
- immunoglobulin should be given to those never vaccinated
- for those with a dirty wound, give a booster after 5 years
- for those with a clean wound, give a booster after 10 years
Who is the meningococcal vaccine indicated for?
- indicated at age 11 for all individuals
- indicated for adults with asplenia, terminal complement deficiency, military recruits, residents of college dorms, and those with HIV
Describe HepA post-exposure prophylaxis.
- it is indicated for household and sexual contacts
- for individuals between 12 and 40 years old, HepA vaccination is sufficient
- for those outside 12-40, have liver disease, or are immunocompromised, also give immune globulin
Describe who should receive HepB post-exposure prophylaxis and what they should receive.
- indicated for needle-stick and sexual exposures to those positive for HBsAg if patients don’t have anti-HBs
- give immune globulin and vaccination unless patients already have anti-HBs
What is used as pre-eclampsia prophylaxis and when is it started?
aspirin after 12 weeks gestation for women at high risk
For whom are statins recommended?
- those with clinical atherosclerotic disease
- those with LDL greater than 190
- those 40-75 with diabetes and LDL 70-189
- those 40-75 with an LDL 70-189 and ASCVD of 7.5% or greater
