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Level 2 Study > Preventative Medicine > Flashcards

Preventative Medicine Flashcards

1
Q

What are the four malignancies for which regular screening is recommended?

A
  1. colon
  2. breast
  3. cervix
  4. lung
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2
Q

What are the guidelines for colorectal cancer screening?

A
  • If no significant family history, start at 50 (or 45)
  • If single first-degree reative <60 start at 40 or 10 years before relative was diagnosed
  • gFOBT every 1 year
  • FIT every 1 year
  • FIT-DNA every 1-3 years
  • CT coongraph every 5 years
  • flexible sigmoidoscpy every 5 years
  • colonography every 10 years
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3
Q

What are the guidelines for breast cancer screening?

A
  • mammography every 1-2 years from 50-74
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4
Q

What are the guidelines for cervical cancer screening?

A
  • starting age 21 Pap smear every 3 years until 65
  • Pap smear +HPV testing every 5 years, age 30-65
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5
Q

What are the guidelines to screen for lung cancer?

A
  • low-dose CT every 1 year for adults 50-80 with 20-pack-year smoking history and currently smoke or have quit within 15 years
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6
Q

What age do we start screening for osteoporosis?
What sites are most commonly used?

A
  • > 65
  • spine, hip, forearm
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7
Q

What factors increased risk of osteoporosis and therefore require screening earlier?

A
  • parental history of hip fracture
  • smoking
  • alcohol use
  • low body weight
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8
Q

What are the Z-score and T-score?

A
  • Z-score: compares bone density to peers
  • T-score: compares bone density to healthy young adult
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9
Q

How is osteoporosis/osteopenia diagnosed?

A
  • osteopenia: T-score of -1 to -2.5
  • osteoporosis: T-score -2.5 or lower
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10
Q

Initial treatment plan for patients with osteoporosis?

A
  • start bisphosphanates
  • oral daily calcium supplementation
  • vitamin D
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11
Q

What are the guidelines for cholesterol screening?

A
  • men with no risk factors for coronary artery disease: 35
  • men & women with risk factors: routinely after 20
  • low-risk individuals: repeat in 5 yrs
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12
Q

What are the diagnostic criteria for Diabetes Mellitus?

A
  • two fasting glucose measurements >125
  • HbA1c >6.5%
  • random glucose >200mg/dL with symptoms
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13
Q

What are the symptoms of Dibetes Mellitus?

A
  • frequent urination
  • extreme thirst/dry mouth
  • fatigue
  • increased appetite
  • unexplained weight loss
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14
Q

What are the screening guidelines for Diabetes Mellitus?

A
  • asymptomatic + overweight: 33-70
  • asymptomatic + hypertension, hyperlipidemia, first degree relative with DM
  • everyone >18 with elevated blood pressure (at every visit)
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15
Q

What are the screening guidelines for abdominal aortic aneurysm?

A

men 65-75 who have ever smoked

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16
Q

What are recommendations for the following vaccine + travel?

Hepatitis A

A

all travelers to developing nations
* if departing within 2 weeks, give vaccine + immune serum globulin
* booster shot 6 months later (immunity 10 yrs)

17
Q

What are recommendations for the following vaccine + travel?

Hepatitis B

A

all people traveling to areas of high prevalence + plan to receive medical/dental care while there (including tattoo & acupuncture)

18
Q

What are recommendations for the following vaccine + travel?

typhoid

A

traveling to developing nations & will have prolonged exposure to contaminated food and water
* live attenuated: 4 doses given orally repeated every 5 yrs
* capsular polysaccharide (preferred): given IM 1x & repeated every 1-2 yrs

19
Q

What are recommendations for the following vaccine + travel?

polio

A

those traveling to developing nations
* if not previosly vaccinated: 3 doses of inactivated vaccine
* if previously vaccinated: one-time booster

20
Q

What are recommendations for the following vaccine + travel?

Rabies

A

were rabies is common among domesticated animals
(India, Asia, Mexico)

21
Q

What are the guildelines for malaria prophylaxis for traveling? Slide effects?

A
  • mefloquine (1x/week) - neuropsychiatrics effects ie. hallucinations, depression, unusual behavior
  • doxycycline acceptable alternative - photosensativity
  • chloroquine in pregnancy
22
Q

What are the guidelines for Tdap vaccination in US?

A

most receive primary immunization as child - for those that do no, give 3 doses
* first 2 doses 1-2 months apart (first should be Tdap, all others can be Tdap or Td)
* third dose 6-12 months later
* booster every 10 yrs for life
* if patient receives dirty wound, revaccinate after 5 yrs

23
Q

What are the guidelines for pneumococcal vaccination in the US?

A
  • all adults >65
  • sickle-cell disease or asplenia
  • cardiopulmonary disease, cirrhosis, diabetes, alcoholism, cigarette smoking
  • immunocompromised status
  • booster dose for patients <60 when they received primary dose
24
Q

What are the guidelines for Hepatitis B vaccination in US?

A
  • all children though age 18
  • those with STIs
  • Sexually active but not monogomous
  • occupational exposure to blood
  • prison inmates
  • travelers to countries endemic with hep B
  • history IV drug use
  • HIV infection
  • MLM sexual contact
  • history chronic liver disease
25
Q

What are the guidelines for Hepatitis A vaccination in US?

A

2 types: inactvated hep A & live-attenuated
2 doses: initial dose & booster given 12-23 months later
* strongly recommended in children 12-23 mo. in an attempt to eradicate the diseae
* sexual or occupational activity puts them at risk
* chronic liver disease
* HIV infection
* drug use
* have been treated wiht clotting factor concentrates
* live where outbreak is present
* traveling to India, Africa, Central America, South America, Far East, Eastern Europe

26
Q

What vaccinations should a patient receive before a splenectomy? Timeline?

A

pneumovax, meningococcal, haemophilus
2 weeks prior

27
Q

What are the guidelines of adult varicella vaccination in the US?

A
  • all adults who lack history of childhood infection
28
Q

Live, attenuated vaccines are contraindicated for what groups?

A
  • HIV-positive + symptoms or CD4 <200
  • immunocompromised
  • pregnant
29
Q

What are the guidelines for adult MMR vaccination?

A
  • healthy adults born after 1956 (1 dose)
  • HIV-positive but asymptomatic + CD4 >200
30
Q

Guidelines for meningococcal vaccination in US?

A
  • everyone at age 11
  • young adults in dorms/barracks
  • exposed to outbreak
  • asplenia or terminal complement deficiencies
  • traveling to endemic region
  • exposed to Neisseria meningitidis
31
Q

Guidelines for HPV vaccination?

A
  • age 9-26 regardless of sexual activity
    3 doses: 0, 2, and 6 months
32
Q

Guidelines for herpes zoser vaccination?

A

Zostavax for >60 whether have had shigles or not; single injection
Shingrix (preferred by CDC) for >50; 2 doses 2-6 months apart- patients can still receive if have already had shingles, zostavax, or are unsure if they ever had chicken pox

33
Q

How do you screen for inappropriate alcohol use? What indicates a positve result?

A

CAGE; 2 “yes” is positive
* Ever felt need to CUT down on drinking?
* Ever felt ANNOYED by criticism of drinking?
* Ever felt GUILTY about drinking?
* Ever felt the need to take a morning drink (EYE openerr)?

34
Q

What are the pharmacologic treatments to help with smoking cessation? What are their risks?

A
  • buproprion (lowers seizure threshold - do not use with alcohol abuse)
  • varenicline (increased rate of SI - screen for depression)

Level 2 Study (4 decks)

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