Preventative Medicine Flashcards
breast cancer screening
- mammography
- start at age 50
- stop at age 75
-self examination is NOT recommended
tamoxifen
prophylaxis tx for asymptomatic women with multiple first-degree relatives
- inc DVT and PE and endometrial cancer risk
- dec risk of fractures
trastuzumab
- tx for HER2/neu breast cancer
- not prophylactic
Pap smear
- start at age 21
- every 3 years until age 30
- after age 30: combing e with HPV and test every 5 years
- stop at age 65
colon cancer screening
- colonoscopy starting at age 50
- repeat every 10 years
-FHx: age 40 or ten years before relative’s px
HNPCC
- 3 relatives, 2 generations, 1 premature
- colonoscopy starting at age 25, ever 1-2 years
famililal adenomatous polyposis screening
sigmoidoscopy (since polyps are through ENTIRE colon)
-start at age 12 and then every year
prostate cancer screening
NONE
- PSA tracks current disease, but does not reduce mortality
- DRE does not reduce mortality
lung cancer screening
NONE
osteoporosis screening
- DEXA scan
- 1 SD below average = osteopenia
- 2 SDs below average = osteoporosis
-women at age 65
lipid screening
- men age 35
- women age 45
lipid goals?
HDL > 40
LDL < 100 for CAD & equivalents
LDL < 70 for CAD + DB
CAD equivalents
carotid disease
peripheral artery disease
DB
aortic disease
DB screening
-fasting blood glucose > 126
-oral glucose tolerance test > 200
Hgb A1C > 6.5%
abdominal aortic aneurysm screening
- all men 65-75
- any smoking history
alcoholism screening
- self diagnosed
- CAGE questions: cut down, annoyed about questions, guilt
influenza vaccine =
- influenza A and B
- strains from previous year
- inactived (killed) injection
- healthcare workers, pregnant, elders
pneumococcal vaccine
-protects against Strep pneumonia
- splenectomy pts
- chronically ill (respiratory, heart, kidney, liver disease)
- 65+
- one revaccination after 5 years
herpes zoster vaccine
- protects against shingles
- reduces incidence & severity
- to avoid post-shingles neuropathy
- 60+
hepatitis A vaccine
given to those with chronic liver disease, MSM, IV drug users, infected close contacts, travelers
hepatitis B vaccine
given to those with chronic liver disease, MSM, IV drug users, healthcare workers, dialysis patients, DIABETICS
tetanus toxoid booster (Tdap)
- booster after 10 years
- 5 years after a dirty wound
-Ig is for unvaccinated patients who are exposed to dirt
meningococcal vaccination
- children age 11
- splenectomy pts
- sickle cell pts
- military, college dormitories
