Preventative Medicine

Question 1

Which specific cancer screening test lowers mortality the most?

Answer 1

Mammogram once > 50 years old (more mortality benefit than> 40 years old)

Question 2

When does cervical cancer screening stop? When does mammogram stop?

Answer 2

Last PAP at 65

Last mammogram at 75

Question 3

Lung Cancer Screening v. AAA Screening

Answer 3

Low dose CT annual once 55 yo if 30 pack years hx (must quit for 15 years)

AAA - one time at 65 (or 65-75 if family hx)

Question 4

Lipid, BP and DM Screening Indications

Answer 4

Lipids - 35 for men, 45 for women, + anyone with DM, HTN, CAD or coronary equivalent

BP - every visit once 18

DM - only fasting or HbA1c if risk factors (HLD, obese, HTN)

Question 5

DEXA

Shingles Vax

Pneumo Vax

Answer 5

DEXA - at 65

Pneumo at 65 (13 then 23 6-12 months later)

Shingles - 50

Question 6

What is the most effective medication for smoking cessation?

Answer 6

Varenicline

Question 7

What other special populations should get pneumonia vaccine?

Answer 7

Chronic heart, lung or liver disease

HIV/AIDS

Patients on steroids

Immunocompromised from aspenia or cancer

DM

Cochlear implant

CSF leak

Alcoholic / smokers

Question 8

Post-Exposure PPX for Hep A v. Hep B

Answer 8

A - exposure means household contact, sexual contacts, unvaccinated daycare workers; give single dose of vaccine if age 12 mo - 40 yrs (if >40 yrs old then Hep A IVIG instead of vax)

B - if needle stick or sexual exposure given Hep B IVIG and Hep B vaccine unless person already has protective surface antibody

Question 9

How do you treat possible tetanus?

Answer 9

IVIG if never vaccinated

If clean wound … booster if none in last 10 yrs

If dirty wound … booster if none in last 5 yrs

Question 10

Who should get Hep A v. Hep C vaccination?

Answer 10

A - travelers to endemic areas

B - ESRD on HD, DM, healthcare workers

BOTH - liver disease, IV drug use, men who have sex with men, household contacts with A or B