Preventive Medicine

Question 1

Malignancies with regular screening recommendations:

Answer 1

Breast CA, Colon CA, Cervical CA

Question 2

Colon Cancer Screening Low Risk

Answer 2

Screening at age 50, every 10 years

Question 3

Colon Cancer Screening High Risk

Answer 3

• Significant family history: Single 1st degree relative dx < 60yrs or multiple 1st degree relatives at any age.
• Age 40 or ten years before the youngest member got diagnosed
• Colonoscopy every 5 years
• No screening >75 yrs

Question 4

Breast Cancer Screening

Answer 4

Women who are between 50-74 yrs every 1 or 2 years

Tamoxifen recommended por patients with 2 relatives with BC

Question 5

Cervical Cancer Screening

Answer 5

Age 21 every 3 years until age 65

Question 6

Travel Medicine

Answer 6

4-6 weeks before trip

Profilaxis for:

• Hep A & B
• Malaria, yellow fever and typhoid
• Rabies, polio, meningococcal
• Travelers diarrhea

Question 7

Hepatitis A Profilaxis

Answer 7

• Fecal contamination

- Indication: all travelers to less developed countries, if leaving within 2 weeks–> vaccine + immune serum globulin

Question 8

Hepatitis B Profilaxis

Answer 8

• Patients who plan to have sexual intercourse with local people
• Going abroad for more than 6 months
• If receiving medical or dental care abroad
• Recommended for people who work with indigenous people.

Question 9

Malaria Profilaxis

Answer 9

• Cloroquine (can be used with pregnant women)
• Mefloquine (8 weeks)
• Doxycycline

Question 10

Meningitis Vaccine

Answer 10

• Start at age 11
• Patients traveling to endemic or epidemic areas
• Asplenic patients (benefits the most)
• Terminal C5-C9 (Complement) Deficiencies (benefits the most)

Question 11

Yellow Fever Vaccine

Answer 11

Traveling to endemic areas such as South America

Question 12

Traveler’s Diarrhea

Answer 12

1: EDUCATE PATIENT

• If it happens: Loperamide ( mild loose stools without fever or blood)
• ATB: Fluoroquinolone or Azithromycin (moderate to severe symptoms)

Question 13

Tetanus & Diphtheria

Answer 13

• Most children receive (DTaP)

- Booster (Td) every 10 years

Question 14

Influenza Immunization

Answer 14

• Yearly all children and adults
• Pregnant women in their 2-3 trimester
• Most benefits for patients with: cardiopulmonary disease, DM, hemoglobinopathy, age > 50, residents of chronic health facilities.

Question 15

Pneumococcal Vaccine

Answer 15

Age 60

Any group age if immunocompromised, cirrhosis, splenectomy, alcoholism, cardiopulmonary disease, sickle cell disease

Question 16

Pneumococcal Revaccination

Answer 16

• Healthy patients who were vaccinated under 65 years

- Revaccinate ONCE after 5 years: chronic kidney disease, asplenic patients, immunocompromised patients

Question 17

Hepatitis B Vaccination

Answer 17

• History of chronic liver disease (benefits the most)
• Immunocompromised patients
• Sexual contact
• Syringe contact

Question 18

Varicella Vaccine

Answer 18

• Live attenuated: people who have never had it before

- NOT indicated for: immunocompromised patients, pregnant women, HIV+ sx with CD4+ <200

Question 19

Varicella Zoster Vaccine

Answer 19

• Age > 60

Question 20

HPV Vaccine

Answer 20

Women 9-26 yrs, 3 doses (0,2,6 months)

-Not used in pregnancy

Question 21

Smoking Cessation

Answer 21

• Bupropion (benefits most) or Verencicline
• Follow ups
• Nicotine Patches and gum

Question 22

Osteoporosis

Answer 22

Women age > 65

Women age 60 if low weight or increased risk of fractures

Question 23

Abdominal Aortic Aneurysm

Answer 23

US screening on all smoking male patients over >65

- NO SCREENING FOR: women, non smoker men

Question 24

DM Screening

Answer 24

• Strongest indication for screening: hypertension and hyperlipidemia
• DX of DM: 2 fasting glucoses > 125, HbA1c > 6.5%, Random glucose >200 + symptoms

Question 25

Hypertension Screening

Answer 25

Everyone age >18

Question 26

Alcohol Abuse

Answer 26

CAGE Questionnaire: (+ if 2 are yes)

• Cut
• Annoyed
• Guilty
• Eye Opener