Quiz 2 Flashcards
Which of the following are examples of primary prevention?
Primary prevention aims to prevent disease before it occurs. Vaccinations are examples of primary prevention, because they prevent the disease from occurring. Exercise in a person without disease is also an example of primary prevention, because the goal is to prevent disease from occurring.
Monitoring blood glucose in a person with type 2 diabetes would not be primary prevention, because monitoring blood glucose is not preventing type 2 diabetes from occurring in the first place. Using acupressure to reduce fatigue among breast cancer survivors would also not be primary prevention, because the disease has already occurred and the goal is to prevent further problems associated with breast cancer.
Which of the following are examples of secondary prevention? (select all that apply)
Secondary prevention aims to identify disease in the earliest stages, before the onset of signs and symptoms. This includes regular exams and screening tests to detect disease in its earliest stages. A mammogram in an apparently healthy woman is an example of secondary prevention where the goal is to detect disease early, in the absence of signs and symptoms. HIV testing offered at a health fair is also an example of secondary prevention aimed at detecting disease early, before the onset of signs or symptoms. However, an HIV test in someone with flu-like symptoms would not be secondary prevention, because the person is already exhibiting signs and symptoms of disease. The goal here is diagnosis. Similarly, a strep test in a child with a fever and sore throat is diagnosis, because the child is already ill and exhibiting symptoms
Which of the following are examples of tertiary prevention?
Tertiary prevention aims to manage disease post diagnosis to slow or stop progression. Exercising after having a heart attack is aimed at reducing further heart attack-related morbidity and is therefore tertiary prevention. The goal of living in a half-way house is to prevent the person from relapsing into alcoholism and is tertiary prevention. The goal of a flu vaccine is to prevent the person from getting the flu, so a flu vaccine would be primary prevention. A routine colonoscopy in a person with no history of colon cancer aims to identify disease before the onset of signs or symptoms, and would therefore be secondary prevention.
Being evaluated by a doctor for a mysterious skin rash is considered secondary prevention.
False. Being evaluated by a doctor for a mysterious skin rash is diagnosis. Secondary prevention occurs before symptoms appear but after the biologic onset of disease. Given that a patient already has a skin rash, they would be symptomatic and would be seeking evaluation rather than acting in preventive fashion.
The natural history of disease refers to the historical increasing and decreasing incidence of a specific disease.
False. The natural history of disease refers to the biologic and clinical progression of disease, from before biologic onset of disease all the way until clinical outcome.
All etiologic factors are risk factors.
True. Etiologic factors are causes of disease, and all causes of disease serve as risk factors to disease. Etiologic factors for a disease are always risk factors; for instance, a virus for a disease is a risk factor for getting a disease. However, not all risk factors for a disease are etiologic factors for that disease; something like gender or BMI could be a risk factor, but certainly would not be an etiologic factor for that disease.
At least one level of prevention can be implemented during which of the following points in the natural history of any disease (select all that apply):
All are correct. The prepathogenesis period occurs before biologic onset of disease, when primary prevention can be used to help prevent biologic onset of disease. Early pathogenesis is the early period of disease development, after biologic onset of disease. During this phase, we use secondary prevention. When disease is advanced, we use tertiary prevention.
What level of prevention is initiated during the pre-clinical phase?
Secondary prevention is the correct answer. During the pre-clinical phase, after biologic onset of disease but before symptoms appear, we are able to initiate secondary prevention. The goal of secondary prevention is to prevent severe outcomes among those who already have a disease, but do not have symptoms. Primary prevention can be initiated during the normal phase, which is prior to the pre-clinical phase, and tertiary prevention is initiated during the clinical phase.
Tertiary prevention generally involves programs and initiatives that target large groups of healthy people, while primary prevention focuses on rehabilitating individuals recovering from disease.
False. The opposite is true: Primary prevention generally involves programs and initiatives that target large groups of healthy people, while tertiary prevention focuses on rehabilitating individuals recovering from disease.
Testing for the presence of a mutation in the BRCA1 gene, a gene involved in increasing the likelihood of the development of breast cancer, in a person with a strong family history of breast cancer, is an example of what level of prevention?
None of the above. Testing for the presence of a mutation in the BRCA1 gene would be risk factor identification. The genetic mutation is a risk factor for breast cancer.
This is not screening (secondary prevention) or diagnosis, because detecting the BRCA1 mutation is not the same as detecting disease. Not everyone with the mutation will get breast cancer. (We also know that it cannot be diagnosis, because there is no indication that the person has any symptoms of breast cancer.)
This is not primary prevention, because the genetic test itself will not prevent onset of disease.
We also know that this cannot be tertiary prevention, because the person does not yet have disease.
Risk factor identification can lead to primary or secondary prevention strategies. For example, people who find out that they have the BRCA1 mutation might choose to undergo preventive breast removal (primary prevention) or may seek more frequent mammograms (secondary prevention), but the BRCA1 genetic test itself is not a level of prevention.
