Preventative Health Flashcards
Absolute CV risk factors (8)
Gender Age Systolic BP Smoking status Total cholesterol HDL cholesterol Diabetes ECG LVH
Modifiable CV risk factors
Smoking status BP Serum lipids Waist circumference and BMI Nutrition Physical activity level Alcohol intake
Non-modifiable CV risk factors
Age
Sex
Family history of premature CVD
Social history incl cultural identity, ethnicity, and SES
Automatic high risk CVD (6)
Diabetes and age >60 Diabetes with microalbuminuria Moderate to severe CKD (eGFR <45) Previous dx of familial hypercholesterolemia SBP >=180 or DBP >=110 Serum cholesterol >7.5
High risk for kidney disease (8)
Smoking Obesity Family history of kidney failure Diabetes HTN ATSI age >30 Established CVD, coronary heart disease, or PVD History of acute kidney injury
Kidney disease screening tests (3)
BP
ACR - if positive, repeat twice over two months
eGFR - if <60, repeat within 7 days
Do every 1-2 years - annually for HTN and DM
When may eGFR be unreliable? (7)
Acute changes in renal function
Dialysis
Certain diets (vegetarian, high protein, recent ingestion of cooked meat)
Extremes of body size
Muscle diseases (overestimate) or high muscle mass (underestimate)
Children <18
Severe liver disease
Travel health areas
Safe food and water
Immunisations (3R’s - routine, required, recommended)
Avoid animal bites
Avoid mosquito bites
Travel insurance
Chronic disease management
Traveller’s diarrhea management (oral rehydration, etc)
Basic medical kit
Air travel safety, DVT prevention
Safe sex
Register travel at smartraveller.gov.au and subscribe to travel advisories of countries visiting
Diabetes mellitus diagnosis criteria
Symptomatic with fasting BSL at or greater than 7.0 or random at or above 11.1 mmol/L OR HbA1c at or above 6.5% (48mmol/mol)
OR
Asymptomatic with TWO abnormal blood glucose tests
AUSDRISK criteria (10)
Risk of developing diabetes in 5 years (LOW 5 or lower, INTERMEDIATE 6-11, HIGH 12 or higher)
Age group Gender Ethnicity(Indigenous, Pacific Islander, Maori) and country of birth (Asia, Middle East, Northern Africa, Southern Europe) 1° relatives with diabetes Previous high sugar On hypertension medication Current smoker Fruit/veg everyday At least 2.5 hr of exercise per week Waist measurement + Asian or Indigenous
3 C’s of measles
Cough
Coryza
Conjunctivitis
(with fever)
2-4 day prodrome before rash typically
Infectious from day before prodrome to 4 days after rash onset
Previously vaccinated people may present atypically
Pre-Op Anaesthetics History (5-6) and Exam (4)
Past hx of anaesthetics issues Family hx of anaesthetics issues Reflux Teeth Exercise tolerance (2 flights of stairs) Fasted (on the day)
Mallampati score
Jaw opening
Thyro-mental distance (at least 7cm from thyroid to tip of jaw with head extended)
Neck mobility
Drugs that commonly cause Stevens-Johnson syndrome
Risk factors
Allopurinol Carbamazepine Lamotrigine “-oxicam” anti-inflammatories Phenytoin Sulfa drugs Sertraline Phenobarbital
Viral infections Weakened immune system Previous hx of SJS Family hx of SJS Chinese people with certain HLA genes
Safety planning steps (8)
Recognise warning signs and triggers Create a safe environment Identify reasons to live Things I can do by myself People and places I can connect with Personal contacts Professional contacts Follow-up and review
Waist circumference - risk range for men and women
Men 94-102cm, greatly increased risk >102
Women 80-88cm, greatly increased risk >88cm
SCOFF questions
Make yourself SICK when you feel uncomfortably full?
Worry you have lost CONTROL over how much you eat?
Recently lost more than ONE stone (6.35kg) in 3 months?
Believe you are FAT when others say you are too thin?
Would you say FOOD dominates your life?
2 or more suggest an eating disorder
Pre-anaesthetic check (5)
GA +/- FH GORD Exercise tolerance Teeth Fasting
High risk of T2DM (7)
Previous IGT or IFG CVD (e.g. AMI, angina, PVD, stroke) Age 35 or older from Pac Islands, Indian subcontinent, or China Age 40 or older with BMI over 30 or HTN Gestational DM PCOS Antipsychotics or steroids
Red flags at 6 months (6)
Not smiling or squealing in response to people.
Not starting to babble.
Not reaching for and holding toys.
Hands frequently clenched.
Not rolling.
Not holding head and shoulders up when on tummy.
Red flags at 9 months (8)
Not sharing enjoyment with others using eye contact or facial expression.
No gestures.
Not using 2-part babble, e.g. gaga.
Unable to hold and/or release toys.
Cannot move toy from one hand to another.
Not sitting without support.
Not moving, e.g crawling.
Does not take on weight well on legs when held by an adult.
Red flags at 12 months (10)
Does not notice someone new.
Does not play early turn-taking games, e.g. peekaboo, rolling a ball.
No babbled phrases that sound like talking.
No response to familiar words.
Majority of nutrition still liquid/puree.
Cannot chew solid food.
Unable to pick up with index finger and thumb.
Not crawling or bottom shuffling.
Not pulling to stand.
Not standing holding on to furniture.
Febrile seizures: simple vs complex (4)
Simple is fever plus all: Generalised tonic-clonic Duration less than 10min Complete recovery within 1 hour Does not recur in the same febrile illness
Usually occurs between 6 months and 5 years.
In 3% of healthy kids
Normally associated with simple viral infections
No risk factors: 1% risk of epilepsy (same as general pop)
Acute rheumatic fever diagnosis (major and minor criteria)
Initial:
2 major or 1 and 2 minor plus evidence of preceding GAS infection (elevated antiDNase or ASOT or throat swab)
Recurrent:
2 major or 1 and 1 or 3 minor plus evidence of GAS
Major (high risk):
- carditis
- polyarthritis, aseptic monoarthritis, or polyarthralgia
- chorea
- subcutaneous nodules
Minor (high risk):
- monoarthralgia
- fever 38°C or higher
- ESR or CRP >30
- prolonged PR on ECG
Acute rheumatic fever management
NOTIFIABLE DISEASE!!!
Benzathine benzylpenicillin IM single dose (900mg/2.3mL in adults)
OR
If compliance ok then phenoxymethylpenicillin (kids 15mg/kg up to) 500mg bd for 10 days
OR cephalexin (25mg/kg up to) 1g bd for 10 days
OR azithromycin (12mg/kg up to) 500mg daily for 5 days
For arthritis or severe arthralgia, use aspirin 50-60mg/kg in 4 to 5 divided doses OR naproxen 5-10mg/kg up to 625mg bd.
In kids, flu shot is advised to reduce virus-induced Reye syndrome with aspirin. Consider stopping in acute viral illness.
