Preventative care

Question 1

When should you screen for G/Cl

Answer 1

between 13 to 24 yrs if sexually active, after 25yrs only if high risk

Question 2

When to screen for diabetes

Answer 2

Annually if high risk, every 3 years at age 45

Question 3

When to screen for hyperlipidemia

Answer 3

Every 5 years beginning at age 21

Question 4

When to screen for osteoporosis

Answer 4

Beginning at age 65 or sooner with risk factors, every 2 years

Question 5

HIV screening

Answer 5

At least once during lifetime, annually if high risk ages 13-64

Question 6

Hep C screening

Answer 6

At least once in lifetime for adults >18yo

Question 7

What is unhealthy alcohol use for women

Answer 7

> 7 drinks/week or >3 drinks per day

Question 8

What is TACE

Answer 8

Tolerance– how many drinks needed to “feel it”
Annoyed– do you get annoyed when someone questions your drinking
Cut down– has anyone told you to cut down
Eye opener– do you ever drink shortly after waking

Question 9

What are the 5 As

Answer 9

Ask – about smoking
Advice – to stop smoking
Assess – pt willingness to stop smoking
Assist – with counseling, support, materials
Arrange – follow up

Question 10

What health effects can occur with smoking in pregnancy?

Answer 10

IUGR
PPROM
Low birth weight
Previa
Abruption
Decreased maternal thyroid function
Ectopic pregnancy
Increased perinatal mortality
Increased SAB and recurrent SAB

Question 11

What is the recommended amount of Vit D a day?

Answer 11

600 IU/day for ages 1-70 and pregnancy
800 IU/day if >70

Question 12

When to screen for colon cancer

Answer 12

Age 45 in pts with avg risk

If fam hx, 10yrs prior to diagnosed age

Stop at age 85 (after 75 is shared decision making)

Question 13

What are screening options for colon cancer

Answer 13

Yearly with fecal blood card
Annual fecal blood AND flex sig q5 years
Annual FIT and sigmoidoscopy q 10yrs
CT colongraphy q 5yrs
Cologuard q 3 yrs
Colonoscopy every 10 years

Question 14

Lung cancer screening

Answer 14

Low dose chest CT
- annually for all smokers with 20 pack year history at age 50-80 who either still smoke or quit less than 15 years ago

Question 15

breast cancer screening

Answer 15

Annual after age 40, no later than age 50

Stop at 75

Question 16

BRCA risk of cancer

Answer 16

BRCA 1
Breast– 45-85%
Ovarian– 39-46%

BRCA2
Breast– 45-85%
Ovarian– 10-27%
Male breast cancer– 6%
Prostate, melanoma

Ov cancer usually high grade and serous or endometriod

Question 17

Breast cancer screening in BRCA

Answer 17

Commence annual MRI with contrast at 25
Annual MRI and mammogram at 30
Clinical breast exam at 25, every 6 months
Chemoprophylaxis with Tamoxifen (BRCA2)
Consider surgical risk reduction

Question 18

When is tetanus vaccine recommended

Answer 18

Td every 10 years (except 1x booster with Tdap)
Tdap every pregnancy

Question 19

When is MMR vaccine recommended

Answer 19

Single dose if never vaccinated or no immunity

Question 20

Hep A vaccine recs

Answer 20

International travel, children 12-23mo, IV drug users

Question 21

Hep B vaccine recs

Answer 21

Given within 12 hrs of birth
All people <60 or >60 who want it

Question 22

Pneumococcal vaccine recs

Answer 22

Age 65 years or 19-64 who are immunocompromised, chronic lung disease, DM or splenectomy

Question 23

Meningococcal vaccine recs

Answer 23

1st dose 11-12 yrs, booster age 16

Question 24

Zoster vaccine recs

Answer 24

Two dose series for all adults aged 50 and older

Question 25

HPV vaccine recs

Answer 25

9-45yrs old

2 shots before age 15 at 0, 6months
3 shots thereafter at 0, 2, 6 months

Covers 6, 11, 16, 18, 31,33, 45, 52, 58