Primary Care Boring Stuff Flashcards
What population to consider ASA for primary prevention
Ages 50 - 69 with ASCVD >10%
Frequency of NODAT screening post-txp
Qweek x4wk then Q3 mo x1 year then annually
FBG, A1c, OGTT
Dx of DM
FBG >126
A1c > 6.5%
OGTT >200
Dx Pre-Dm
FBG >100
A1c >5.7%
OGTT >140
HLD Screening
2-3 months post-txp then annually
Statin benefit groups
- LDL >190 [high]
- DM, age 40-75 [mod-high]
- ASCVD 7.5-20%, Age 40-75, no DM [moderate]
- ASCVD >20%, Age 40-75, no DM [high]
- Clinical ASCVD [mod-high pending age, individual risk]
Breast CA Screening
Q2 years at age 50-74
Prostate CA Screening
PSA in men 55 - 69
PTLD Screening
Exam Q3 months
Colon CA Screening
Screening at age 50: colo Q10 OR flex sig Q5 OR stool-test annually
Cervical CA Screening
Q3 years
Skin CA Screening & how soon to get first exam
Annual exam:
- within 2 years if high risk caucasian (old, thoracic txp, male)
- within 5 years if AA or low-risk caucasian
RCC Screening
For high risk (acquired cystic, family hx, smoker), native kidney US Q1-2 years
Screening for HCC Patients
CT/MRI Q6-12 months x3 years
+/- AFP measurements
PSC with IBD Screening for Colon CA
Colo annually with biopsy
How soon can inactive vaccine be given pre-txp?
At least 2 weeks
How soon can live vaccine be given pre-txp?
At least 4 weeks
How soon to give inactive vaccine post-txp
Flu: at least 4 weeks
All others: at least 8 weeks
Vaccine series of Zoster (Shingrix)
0 months
2-6 months
Age for Shingrix
50+
TIme to wait between Shingles and Shingrix vaccine
1 year
Who should get PCV13 vaccine? (adults)
Everyone x1 in lifetime
PPSV23 Schedule
#1: 8 weeks after PCV13 #2: 5 years after #1 #3: after age 65 (and 5 years after #2)
Hepatitis B Schedule
Engerix or Recombivax: 0, 4 weeks, 24 weeks
Heplisav-B 0, 4 weeks
Consider checking HbsAb titer ~4 weeks after final dose. If HBsAb <10 consider completing series again using high-dose
Vaccines required if eculizumab
- MenACWY (Menactra, Menveo - interchangable)
2. MenB (Bexsero, Trumenba - not interchangable)
Which mening vaccine cannot be given with PCV13?
Menactra. Associated with reduced PCV IgG.
Vaccines required if asplenic
- MenACWY (Menveo pref if needed to give PCV13 at same time)
- MenB
- Hib
- PCV13
- PPSV23
BMD screening
Kidney: within first 3 months if on CS-containing regimen or high risk for osteoporosis
Liver: annually if osteopenic; Q2-3 years if normal BMD
Who should get MenACWY vaccine?
Recommended for everyone: 1st dose at 11-12 years and 2nd dose at 16 years
For adults at risk:
Menveo schedule?
Menactra schedule?
For BOTH MenACWY:
2 doses 8 weeks apart then re-vaccinate Q5 years if risk remains
Who should get MenB vaccine?
People 10+ at risk for meningococcal disease (asplenia, eculizumab)
For those at risk:
Trumenbo schedule?
Bexsero schedule?
Trumenba: 3 doses, at 0, 1-2, and 6 months
Bexsero: 2 doses, 4 weeks apart
1 dose MenB booster 1 year after primary series and revaccinate every 2–3 years if risk remains
Who should get HPV vaccine?
Males & females 9 - 45 yeras of age
HPV vaccine schedule
3 doses at 0, 1-2 and 6 months
MMR schedule (pediatrics)
2 doses at 12-15 months and 4-6 years
may accelerate to 4 weeks betwen the 2 doses
Adults without immunity to MMR/born AFTER 1958: vaccine schedule
1 dose
